Adams J H, Graham D I, Murray L S, Scott G
Ann Neurol. 1982 Dec;12(6):557-63. doi: 10.1002/ana.410120610.
Forty-five cases of diffuse axonal injury (DAI) brought about by nonmissile head injury in humans are analyzed and compared with 132 cases of fatal head injury without DAI. All cases were subjected to a comprehensive neuropathological study. In the patients with DAI a statistically significant lower incidence of lucid interval, fracture of the skull, cerebral contusions, intracranial hematoma, and evidence of high intracranial pressure were found, with a higher incidence of head injury due to road traffic accident. Brain swelling and hypoxic brain damage were not statistically different in the two groups. The features of DAI in humans are compared with the DAI that has been produced in subhuman primates by pure inertial loading brought about by angular acceleration of the head. The available evidence indicates that DAI in human beings occurs at the time of head injury and is not due to complicating factors such as hypoxia, brain swelling, or raised intracranial pressure.
对45例因非投射性头部损伤导致的人类弥漫性轴索损伤(DAI)病例进行了分析,并与132例无DAI的致命性头部损伤病例进行了比较。所有病例均接受了全面的神经病理学研究。在DAI患者中,发现清醒期、颅骨骨折、脑挫伤、颅内血肿以及高颅内压证据的发生率在统计学上显著较低,因道路交通事故导致头部损伤的发生率较高。两组在脑肿胀和缺氧性脑损伤方面无统计学差异。将人类DAI的特征与通过头部角加速度产生的纯惯性负荷在非人灵长类动物中产生的DAI进行了比较。现有证据表明,人类DAI发生在头部受伤时,并非由缺氧、脑肿胀或颅内压升高等复杂因素引起。