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- Takeda Munekazu
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
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- Iwai Kaori
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
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- Yamada Sou
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
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- Harada Tomoyuki
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
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- Abe Masaru
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
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- Yaguchi Arino
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
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Diffuse axonal injury (DAI) commonly causes immediate loss of consciousness after head injury. We report the case of a 20-year-old man who was involved in a motor vehicle accident, which his estate car ran into a truck from behind. Although he was alert on arrival at the hospital, his conscious level deteriorated approximately 7 hours after the accident. At this time point, he had a generalized tonic seizure and decorticate posturing of his arms with a Glasgow coma scale (GCS) score of 5. MRI revealed findings consistent with DAI. On the 14th day, his conscious level improved to a GCS of 9 and MRI showed chronic DAI. The patient recovered well with only mild memory deficit at discharge. There are few reports of delayed onset DAI, but in terms of its neuropathology, it is possible for it to occur after the time of injury. DAI is the result not only of direct injuries to the axon membrane and axonal sheath due to shearing force, but also of secondary injury by loss of axon transport. In the emergency department, a diagnosis of DAI should be considered in any patient who has suffered head injury by rotational forces even if there is no loss of consciousness on arrival at the hospital.
収録刊行物
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- 日本救急医学会雑誌
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日本救急医学会雑誌 20 (7), 383-389, 2009
一般社団法人 日本救急医学会
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詳細情報 詳細情報について
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- CRID
- 1390282679346117376
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- NII論文ID
- 130004542240
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- ISSN
- 18833772
- 0915924X
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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