Diffuse axonal injury

[HillaryC, RN, CRNA]

Hi everyone,

I recently transferred from SIMC to a SICU that frequently gets neuro patients. I had a 30 yo male pt. this week s/p MVC with a diagnosed "diffuse axonal injury". I'm new to SICU and have very little experience with neuro patients. I was hoping someone might be able to tell me more about this kind of injury. I checked on the pt. yesterday and he still hasn't woken up (7 days post MVC). I only had him for part of one shift, but what I know is he had a Camino that was d/c'ed 2 days after the accident and he still hasn't opened his eyes 7 days out (he's not being sedated).

What kind of recoveries have you all seen from this kind of injury?

Thanks,

Hillary

[RoxanRN]

Hi everyone,

I recently transferred from SIMC to a SICU that frequently gets neuro patients. I had a 30 yo male pt. this week s/p MVC with a diagnosed "diffuse axonal injury". I'm new to SICU and have very little experience with neuro patients. I was hoping someone might be able to tell me more about this kind of injury. I checked on the pt. yesterday and he still hasn't woken up (7 days post MVC). I only had him for part of one shift, but what I know is he had a Camino that was d/c'ed 2 days after the accident and he still hasn't opened his eyes 7 days out (he's not being sedated).

What kind of recoveries have you all seen from this kind of injury?

Thanks,

Hillary

Diffuse axonal injury is the shearing/tearing/stretching of the brain's long connecting nerve fibers (axons) which occurs when the brain is injured as it shifts and rotates inside the bony skull. ICP monitoring generally is not useful as they usually have normal ICPs.

Prolonged recovery is the norm - if they recover. This injury has a poor prognosis. If they do recover, there will almost certainly be deficits - personality changes, motor difficulties (poor coordination, paralysis, spasicity, etc), changes in senses, sided neglect, spacial discernment difficulties (limbs in relation to body), aphasia, dysphagia, impaired ADL ability... the list goes on and on. They will forever need day-to-day assistance/care.

Hope this helps. It's all I could come up with on the spur of the moment :)

Roxan, RN

Neuro Critical Care Unit

[HillaryC, RN, CRNA]

Roxanne,

Thanks so much for the information. It helps a lot!

Hillary

Diffuse axonal injury is the shearing/tearing/stretching of the brain's long connecting nerve fibers (axons) which occurs when the brain is injured as it shifts and rotates inside the bony skull. ICP monitoring generally is not useful as they usually have normal ICPs.

Prolonged recovery is the norm - if they recover. This injury has a poor prognosis. If they do recover, there will almost certainly be deficits - personality changes, motor difficulties (poor coordination, paralysis, spasicity, etc), changes in senses, sided neglect, spacial discernment difficulties (limbs in relation to body), aphasia, dysphagia, impaired ADL ability... the list goes on and on. They will forever need day-to-day assistance/care.

Hope this helps. It's all I could come up with on the spur of the moment :)

Roxan, RN

Neuro Critical Care Unit