双语病例弥漫性轴索损伤DAI

History:A26-year-oldmanwithlossofconsciousnessafterbeingstruckbyanautomobileashewaswalking.

病史：26岁男性，步行时被汽车碰撞，意识丧失。

AxialheadCTimagesinsoft-tissuewindowareshownbelow.

头颅CT轴位软组织窗如下所示。

MRimages

Afteraright,frontalapproachventriculardrainwasplacedandthepatientwasstabilized,brainMRIwasperformed.AxialT1-,T2-,andT2-weightedfluid-attenuatedinversion-recovery(FLAIR),diffusion-weighted(DWI),apparentdiffusioncoefficient(ADC),andgradient-recalledecho(GRE)MRimagesoftheheadareshownbelow.

右额入路行脑室引流，病人状态稳定后，行颅脑MRI扫描。

轴位T1WI、T2WI、T2水抑制

DWI、ADC图

梯度回波成像

（磁敏感加权成像SWI）

Findings

HeadCT:Significantsoft-tissueswellingisseenovertherighttemporoparietalconvexity.Multiplehyperdensefociareseenthroughoutthebrain,predominantlyinthewhitematterandgray-whitejunctionintherightfrontalandparietallobes.Thereisahyperdenselesionintheleftbrainstemextendingintotheleftcerebellarpeduncle.Thereisalsoahyperdenselesioninthespleniumofthecorpuscallosum,extendingintotheventricle.Thesefindingsareconsistentwithintraparenchymalhemorrhagessecondarytodiffuseaxonalinjury.Thereisalsoasmallareaofsubarachnoidhemorrhagealongtherightfrontallobe.

BrainMRI:Aright,frontalapproachventriculardrainwasplaced.Thereislayeringinterventricularhemorrhageinoccipitalhornsbilaterally,therightgreaterthantheleft.Numerousscatteredfociofsusceptibilityartifactrepresentinghemorrhagesareseeninbilateralcerebralhemispheres,spleniumofthecorpuscallosum,dorsolateralrightmidbrain,andpons,







































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