II. Pathophysiology
- Severe Traumatic Brain Injury from rotational acceleration and deceleration forces
- Affects the grey matter-white matter junctions
III. Signs
-
Severe Head Injury (high velocity impact or deceleration injury)
- Coma or severe confusion
- Glasgow Coma Scale (GCS) 8 or less
-
Autonomic Dysfunction
- Fever
- Hypertension
- Diaphoresis
IV. Imaging
-
CT Head
- Diffuse cerebral swelling
- White matter blends into gray
- Punctate Hemorrhages
-
MRI Brain
- Punctate Hemorrhages within white matter tracts
V. Management
- Neurosurgery Consultation
- Intracranial Pressure monitoring and other neurosurgical intervention may be indicated