Is Diffuse Axonal Injury Different in Adults and Children? An Analysis of National Trauma Database

Yehuda Hershkovitz, Boris Kessel, J. J. Dubose, Kobi Peleg, Viacheslav Zilbermints, Igor Jeroukhimov, Adi Givon, Mickey Dudkiewicz, Israeli Trauma Group, David Aranovich

Research output: Contribution to journalArticlepeer-review


Background: Diffuse axonal injury (DAI) is typically associated with significant mechanisms of injury and the effects of acceleration-deceleration forces on brain tissues. The prognosis of DAI remains a matter of active investigation, but little is known about outcome differences between adult and pediatric populations with DAI. Methods: We performed a retrospective cohort study involving blunt trauma patients with DAI between the years 1997 and 2018 from the Israeli National Trauma Registry. The patients were divided to pediatric (age <15 years) and adult (age >15 years) groups, with subsequent comparison of demographics and outcomes. Results: Diffuse axonal injury was identified in 1983 patients, including 469 pediatric victims (23.6%) and 1514 adults (76.4%). Adults had higher Injury Severity Score (20.5% vs 13.2%, P = 0.0004), increased mortality (17.7% vs 13.4%, P < 0.0001), longer hospitalizations (58.4% vs 44.4%, P < 0.001), and higher rehabilitation need rates (56.4% vs 41.8%, P < 0.0001). Associated extracranial injuries were also more common in adults, particularly to the chest. Conclusions: Pediatric patients with DAI have improved outcomes and fewer associated injuries than adult counterparts.

Original languageEnglish
Pages (from-to)62-64
Number of pages3
JournalPediatric Emergency Care
Issue number2
StatePublished - 1 Feb 2022


  • Diffuse axonal injury
  • Head injury
  • Traumatic brain injury


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