CT appearance of shearing injuries of the brain.

Shearing injuries, also called diffuse axonal injuries, are a special kind of severe head trauma, usually caused by a motor vehicle accident, in which disruption of white matter axons takes place. Twelve cases of shearing injuries were diagnosed by computed tomography (CT). The typical CT findings were small hemorrhagic lesions in the cerebral white matter, most often in cerebral hemispheres and internal capsules. In most patients, hemorrhagic foci were multiple. Single lesions were found in only two patients. Features of brain edema were found in eight of ten early studies, and subarachnoidal hemorrhage only in three. Two patients also had subdural hematomas. CT appearance of the shearing injuries is characteristic, especially in connection with clinical data indicating a history of head trauma and severe state of the patient.