Delayed and Sudden-Onset of Diffuse Axonal Injury: A Case Report

Diffuse axonal injury (DAI) is caused by trauma and occurs over a widespread area of the brain. Microscopically, DAI classically presents as axonal swellings, microglial accumulations and debris-laden macrophages. There are minimal gross alterations, which may include hemorrhage within the corpus callosum. A 22 year old male presented after a scooter accident with a GCS of 15 but later deteriorated to a GCS of 3. Three serial CTs were negative except for evidence of hemorrhage in the corpus callosum. The patient was previously diagnosed with Factor IX deficiency which may have contributed to his delayed DAI.