A comparison of manual and semi‐automated methods in the assessment of axonal injury

Diffuse axonal injury (DAI) in the central nervous system is a common cause of post‐traumatic coma and may result in varying degrees of disability up to and including the vegetative state. Experimental studies in man and animals have previously relied upon semiquantitative grading systems for determining the relationship between the extent of DAI and the clinical features of patients. Using β‐amyloid precursor protein immunocytochemistry for the detection of DAI in sections of corpus callosum from 15 cases of fatal head injury, we have developed a quantitative image analysis technique for the assessment of axonal injury. This new method is objective and reproducible and should allow better correlation with biomechanical, radiological, and clinical parameters to increase our understanding of DAI.

[1]  Grace Scott,et al.  Diffuse axonal injury due to nonmissile head injury in humans: An analysis of 45 cases , 1982, Annals of neurology.

[2]  J B North,et al.  Diffuse axonal injury in head trauma. , 1989, Journal of neurology, neurosurgery, and psychiatry.

[3]  D. Graham,et al.  β-Amyloid precursor protein (βAPP) as a marker for axonal injury after head injury , 1993, Neuroscience Letters.

[4]  J. Adams,et al.  Diffuse axonal injury in head injury: Definition, diagnosis and grading , 1989, Histopathology.

[5]  A J McLean,et al.  Topography of axonal injury as defined by amyloid precursor protein and the sector scoring method in mild and severe closed head injury. , 1995, Journal of neurotrauma.

[6]  P. Pilz Axonal injury in head injury. , 1983, Acta neurochirurgica. Supplementum.

[7]  J. Adams,et al.  Diffuse axonal injury and traumatic coma in the primate , 1982, Annals of neurology.

[8]  B Jennett,et al.  Epidemiology of head injury. , 1981, Archives of disease in childhood.

[9]  T. Gennarelli,et al.  The spectrum of traumatic axonal injury , 1996, Neuropathology and applied neurobiology.

[10]  Anthony Marmarou,et al.  A new classification of head injury based on computerized tomography , 1991 .

[11]  J. Clark Distribution of microglial clusters in the brain after head injury , 1974, Journal of neurology, neurosurgery, and psychiatry.

[12]  A J McLean,et al.  Staining of amyloid precursor protein to study axonal damage in mild head injury. , 1994, Lancet.

[13]  D. Graham,et al.  Is β-APP a marker of axonal damage in short-surviving head injury? , 1996, Acta Neuropathologica.

[14]  T A Gennarelli,et al.  Influence of the type of intracranial lesion on outcome from severe head injury. , 1982, Journal of neurosurgery.

[15]  C. Berry,et al.  The pathological concept of diffuse axonal injury; its pathogenesis and the assessment of severity , 1991, The Journal of pathology.

[16]  A. J. McLean,et al.  Stalning af amyloid percursor protein to study axonal damage in mild head Injury , 1994, The Lancet.

[17]  D. Oppenheimer,et al.  Microscopic lesions in the brain following head injury. , 1968, Journal of neurology, neurosurgery, and psychiatry.

[18]  D. Marion,et al.  Treatment of experimental brain injury with moderate hypothermia and 21-aminosteroids. , 1996, Journal of neurotrauma.