Acute hemiplegia secondary to diffuse axonal injury after traumatic brain injury

The diffuse axonal injury (DAI) is one of the main forms of traumatic brain injury, characterized by involvement of the axonal fibres of the white matter of the brain.The mechanism of such injury is the sum of forces of acceleration, deceleration and rotation, mainly in brain structures close to the middle line, including the dorsolateral superior region of the pons and midbrain, splenium of the corpus callosum, parasagittal white matter, and occasionally the internal capsule. Because of the importance of the structures commonly involved and its high incidence, close to 50 % of cases of severe brain trauma, the DAI is a major cause of cognitive impairment as well as the persistent vegetative state related to trauma. However, the occurrence of motor deficit outside of this area is uncommon in literature, and it is obviously dependant on the anatomical region involved6. The objective of this paper is to present a case of hemiplegia secondary to DAI.