Prolonged traumatic coma caused by diffuse axonal lesions
Tominaga, I.; Matsuo, Y.; Kato, Y.; Onaya, M.; Kasahara, M.; Yuzuriha, T.; Oda, T.; Kashima, H.; Wasada, K.
Revue Neurologique (Paris) 147(10): 658-662
1991
ISSN/ISBN: 0035-3787 PMID: 1763255 Document Number: 376408
A 22-year old male patient was admitted for deep coma probably of traumatic origin. There was neither fracture of the skull nor expansive intracranial lesion. The patient survived for 6 years and 8 months without any change in consciousness. Post-mortem neuropathological examination showed lesions which predominated in the white matter and had features that were compatible with diffuse axonal injury. The mechanism responsible for these lesions seems to be stretching and shearing of axones at the moment of impact. The exceptionally long duration of survival probably accounts for the severity of the lesions observed.