Anat Path- DAI

Question 1

Diffuse axonal injury (DAI) is frequently seen in:
a) Falls from heights
b) Sports-related injuries
c) Motor vehicle accidents (MVAs) with unsupported head
d) Penetrating head injuries

Answer 1

C

Question 2

DAI is characterized by:
a) Focal traumatic lesion
b) Purely midline structure damage
c) Changes in axonal cytoskeleton
d) Isolated tearing of blood vessels

Answer 2

Changes in axonal cytoskeleton

Question 3

Mitochondrial dysfunction in DAI leads to:
a) Axonal rupture
b) Neuroinflammation
c) Wallerian degeneration
d) Accumulation of spheroids

Answer 3

A

Question 4

The most severe damage in DAI is typically observed in:
a) Corpus callosum
b) Dorsolateral brainstem
c) Midline structures
d) Other areas

Answer 4

C

Question 5

Severe DAI is characterized by:
a) Immediate unconsciousness
b) Persistent vegetative state
c) Reticular activating substance dysfunction
d) Widespread vascular injury

Answer 5

A

Question 6

Which pathology is commonly seen in DAI?
a) Cerebral infarction
b) Petechial hemorrhages
c) Brain herniation
d) Cystic lesions

Answer 6

b) Petechial hemorrhages

Question 7

Which brain structure is frequently affected by DAI pathology?
a) Hippocampus
b) Frontal lobe
c) Temporal lobe
d) Corpus callosum

Answer 7

D

Question 8

Microscopically, DAI is characterized by the presence of:
a) Axonal rupture
b) Neurofibrillary tangles
c) Spheroids
d) Glial scars

Answer 8

C

Question 9

Which immunohistochemical marker is used to detect DAI?
a) GFAP
b) BAPP
c) S100
d) CD68

Answer 9

B

Question 10

DAI is primarily caused by:
a) Laceration of the brain tissue
b) Increased intracranial pressure
c) Shear forces on the brain
d) Disruption of the blood-brain barrier

Answer 10

C

Question 11

Which term describes the progressive degeneration of axons in DAI?
a) Axonal swelling
b) Neurodegeneration
c) Wallerian degeneration
d) Axonal rupture

Answer 11

C

Question 12

Besides DAI, what other type of pathology can be difficult to separate from other traumatic brain injury (TBI) conditions?
a) Cerebral contusion
b) Epidural hematoma
c) Subdural hematoma
d) Subarachnoid hemorrhage

Answer 12

A

Question 13

What is the characteristic feature of DAI on imaging studies?
a) Hyperdense lesion
b) Ring-enhancing lesion
c) Diffuse white matter abnormalities
d) Midline shift

Answer 13

Diffuse white matter abnormalities

Question 14

Which of the following is associated with DAI?
a) Extradural hemorrhage
b) Subgaleal hematoma
c) Subarachnoid hemorrhage
d) Epidural hematoma

Answer 14

Subarachnoid hemorrhage

Question 15

The mechanism of injury in DAI involves:
a) Direct impact to the brain
b) Rapid acceleration-deceleration forces
c) Projectile penetration
d) Infection

Answer 15

b) Rapid acceleration-deceleration forces

Question 16

Describe the pathophysiology of diffuse axonal injury (DAI).

Answer 16

DAI involves stretching of axons, changes in axonal cytoskeleton, accumulation of mitochondria proximally (spheroids), mitochondrial dysfunction, axonal rupture, neuroinflammation, and Wallerian degeneration. It is a multifaceted process that evolves over time.

Question 17

What are the common clinical presentations of severe DAI?

Answer 17

Severe DAI typically leads to immediate unconsciousness. Patients may recover or enter a persistent vegetative state. Dysfunction of the reticular activating substance may occur. There may also be additional widespread vascular injury in severe traumatic brain injury (TBI) cases.

Question 18

Explain the pathological findings associated with diffuse axonal injury (DAI).

Answer 18

Pathologically, DAI is characterized by petechial hemorrhages in the corpus callosum, dorsolateral brainstem, and other areas due to tearing of blood vessels. Microscopically, axonal swellings (spheroids) are observed, which can be detected using BAPP immunohistochemistry.