Diffuse axonal injuries are generally a severe type of traumatic brain injury. Fortunately, through neuroplasticity, it is possible to encourage recovery in the areas of the brain that were affected to regain abilities you may have lost.
To help through your diffuse axonal injury recovery, we’re covering everything you need to know about these injuries, including the most effective treatment approaches.
Use the following links to jump to a specific section:
- Causes of Diffuse Axonal Injury
- Symptoms of Diffuse Axonal Injury
- Measuring the Severity of a Diffuse Axonal Injury
- Positive Signs of Recovery from Diffuse Axonal Injury
- Neuroplasticity and DAI Recovery
- Effective Methods for Diffuse Axonal Injury Recovery
Causes of Diffuse Axonal Injury
Diffuse axonal injury occurs when the brain quickly moves inside the skull as a result of a traumatic injury, like a car accident. As the brain repeatedly hits against the inside of the skull from the force of the injury, the long connecting fibers in the brain, known as axons, can tear and potentially cause severe damage.
Doctors call this type of injury axonal shearing. The tearing of the axons disrupts the messages that neurons send, leading to a loss of function.
Because most diffuse axonal injuries result in microscopic tears, damage can be difficult to detect with imaging.
Any strong shaking, quick acceleration, or blunt injury can lead to axonal shearing. Some of the most common causes of diffuse axonal injury include:
- Car accidents
- Sports injuries
- Domestic abuse
The severity of the traumatic event is related to a higher potential for axonal shearing.
Symptoms of Diffuse Axonal Injury
The primary symptom of diffuse axonal injury (DAI) is loss of consciousness. For example, if the event causes a significant amount of head trauma and subsequent damage to the axons, the individual could fall into a coma.
Not everyone with a DAI will lose consciousness, though. The other symptoms of this injury include common traumatic brain injury symptoms, such as:
- Severe headaches
- Nausea and vomiting
- Cognitive problems
- Loss of speech
Another secondary effect of DAI is a condition called dysautonomia. Dysautonomia refers to a malfunction of the autonomic nervous system which controls unconscious bodily functions like heart rate, digestion, and breathing.
Symptoms of dysautonomia can include fatigue, low blood pressure, dizziness, and anxiety attacks.
Measuring the Severity of a Diffuse Axonal Injury
One way a physician may determine the severity of a diffuse axonal injury is to refer to the Glasgow Coma Scale (GCS).
The Glasgow Coma Scale is a simple tool that gauges the severity of a TBI and can be used to predict an individual’s prognosis.
It consists of 15 points that measure various functions. A higher score indicates more function, which means a greater likelihood of a positive prognosis.
Positive Signs of Recovery from Diffuse Axonal Injury
Many patients who recover from a DAI demonstrate similar signs. These signs are usually a positive indication of working brain function.
The presence of neurological reflexes is typically viewed as a positive sign of recovery. Following a DAI, physicians may look for:
- Pupillary reactivity. This reflex involves shining a light on the patient’s eyes. If their pupil shrink, it indicates that the brain stem is functioning.
- Oculocephalic response. This reflex checks to makes sure that when the individual’s head is turned to the left, their eyes turn to the right.
- Gag reflex. This reflex tests that the individual gags or coughs when a cotton swab or medical tube is placed in the throat.
Presence of these reflexes is generally viewed as a positive sign of recovery and prognosis.
Neuroplasticity and DAI Recovery
A diffuse axonal injury can affect many areas of the brain at the same time. This can make DAI injuries more difficult to treat than other traumatic brain injuries that only affect one area at a time.
Your recovery from DAI depends on the severity of the injury itself. For example, those who regain consciousness within two weeks have a relatively mild injury and can have a good chance of making a full recovery.
In the more severe DAIs, recovery is difficult to predict. However, regardless of the severity of the injury, it is possible to regain function due to the brain’s natural ability to heal itself.
This natural healing mechanism is known as neuroplasticity. Neuroplasticity occurs when the brain uses healthy functioning nerve cells to form neural connections with the areas of the brain that were affected.
Since a DAI causes problems with communication between neurons, a significant aspect of diffuse axonal injury recovery involves activating neuroplasticity to reform those neural connections.
Effective Methods for Diffuse Axonal Injury Recovery
One of the most effective ways to recover after a diffuse axonal injury is to utilize the principle of neuroplasticity.
During the first few months after a diffuse axonal injury, the brain isheightened state of plasticity.
This is why it’s so important to start rehabilitation as soon as possible after your injury. For the best results, try to incorporate the following therapies into your diffuse axonal injury recovery plan:
1. Physical Therapy
A main goal of physical therapy during recovery from DAI is to regain control over your nerves and muscles.
After a DAI, the connection between the brain, nerves, and muscles are impaired, or damaged. Fortunately, participating in physical therapy can engage the brain and promote neuroplasticity, which is important to recover the areas of the brain that were affected.
There are various interventions a physical therapist may utilize, including:
- Transfer training. Your PT can reteach you how to stand or sit safely, get in or out of a car, or maneuver in the tub/shower.
- Functional electrical stimulation (FES). FES sends electrical impulses to weakened muscles through an electrode that is placed on top of the skin. Combined with functional activities, like walking or stair climbing, these impulses can stimulate the nerves and hopefully improve muscle strength.
- Task-specific exercises. Task-specific exercise is one of the best ways to promote neuroplasticity. Because each movement is associated with a unique set of neural pathways, consistently practicing a certain exercise will help reinforce demand for that specific function.
2. Speech Therapy
If your diffuse axonal injury has affected your ability to speak or swallow, speech therapy is essential.
In addition, speech therapists can teach you various social communication skills that you might lack after DAI, such as learning how to begin and end a conversation. All this makes speech therapy a vital part of diffuse axonal injury recovery.
3. Occupational Therapy
While physical therapy shows you strategies on how to regain your physical mobility, occupational therapy (OT) looks at specific skills you need to regain independence in your home, work environment, or community.
During an OT session, you will practice many important activities that will directly improve your independence. Some areas of your life an occupational therapist can help you with include:
- Personal hygiene
- Managing your finances
- Sorting your prescriptions
- Social skills
- Cognitive functioning
To help you regain these skills, an occupational therapist will teach you both restorative and compensatory strategies:
- Restorative techniques encourage you to perform an activity the way you did before your brain injury.
- Compensatory tactics, on the other hand, help you find an alternative way to accomplish the same tasks.
Whenever possible, all therapists prefer to focus on restorative techniques.
Learning How to Recover From Diffuse Axonal Injury
Diffuse axonal injury is a serious condition and can be one of the most debilitating types of traumatic brain injuries.
But as with all brain injuries, the key to making a good recovery lies in activating neuroplasticity through therapeutic exercises.
The brain is a remarkably adaptable organ, and even if it’s been heavily damaged, there is always the potential for improvement. By persevering with physical, occupational, and speech therapy, you can have a real hope of making a functional recovery.