Severe diffuse axonal injury in adults and children.

Diffuse axonal injury (DAI) occurs in 30% of all fatal head injuries. DAI is identified on autopsy as microscopic lesions that commonly appear in the splenium of the corpus callosum, rostral brainstem and frontal and temporal lobes of the cerebrum. Clinical presentation of severe DAI includes patients with no lucid interval and decorticate or decerebrate posturing. Diagnostic studies describe concurrent pathologic anatomy associated with DAI. The most common mechanism for DAI is motor vehicle accidents. The neuroscience nurse needs to have an understanding of DAI anatomy and physiology, including the differences and similarities in the clinical presentation and neurologic functional outcome in both adult and pediatric populations.