Wondering if anyone might be of help in determining if one has a diffuse axonal injury or a concussion? As in both can happen regardless if an individual has loss of conscious.

Any help greatly appreciated. Thanks.

About: Suffered severe fall in Mid-March. Symtoms= insomnia, fatigue, mall/grocery store over stimuli, brain fog, noise sensitivity, Tinnitus.

A concussion can be a DAI. A DAI can be a concussion.

Why do you ask ?

I was diagnosed with diffuse axonal injury after a high speed MVA. As the name suggests, this sort of injury results in damage to the axons over a large area of the brain.

It often occurs in injuries that involve rapid acceleration and/or rotation.

In my case, I endured a spiral injury when I was cut off by another vehicle. The initial impact sent my head back and forth. The force sent the rear end of my car airborne. It crashed down, blowing out all the tires, and smashing my brain against the top of my skull, before coming to rest perpendicular to the road, sending my head side to side and slamming it into the driver's side window. So, back and forth, up and down, side to side. Basically, my brain did a 360 inside my skull, shaving off precious axons as it went.

Neuro-psych testing revealed that not a single lobe in my brain escaped damage.

In short, where concussion damage might be limited to a small area of the brain, diffuse axonal injury causes widespread damage.

Diffuse axonal patients often display a large number, and variety, of deficits.

Mark is right that sometimes even "mild" concussions will be diagnosed as diffuse axonal injuries.

No matter what label gets applied to your TBI, the important thing is how you're feeling/functioning. Brain injuries are as individual as the people who sustain them. Some folks bounce back well from seemingly devastating injuries, while others struggle for ages after what appeared to be minor bumps. Why? Who knows?

Again, what matters is how you're doing.

Hi Hockey and Mark-

Thanks for your feedback. I hit my jaw/frontal lobe during a fall and then also back of my head. I was heavily disoriented getting up.
i'm trying to peace together if this was a diffuse axonal injury or MBTI. The CT/MRI/MRA came back negative yet that i know does not say much as those technologies cannot image diffuse axonal image nor concussion injuries.

The most annoying attribute has been Tinnitus which has only been in 1 ear and changed it's tones greatly over 3 months. I believe this is a physical issue where by a blood vessel might have been compressed upon my auditory nerve. I'm considering MVD exploratory surgery to help.

the other issue is over stimuli, crowds, malls, etc. I try to believe that this is due to my state of over exhaustion (lack of sleep) from being unable to sleep more than 2 hours per night.

All else life continues with small walks and a strict vitamin regimen per marks suggestion.

Unless you've endured tinnitus, it's hard to imagine how horrible it can be. Both my ears ring, constantly. I also have shooting pain and intermittent deafness. I struck my head right in the area of my temporal lobe and my auditory nerve is damaged.

I try to manage the tinnitus by distracting myself with white noise. I must say, that I really, really miss moments of genuine silence. If you find an effective treatment for this condition, please share it.

That said, I would caution you from jumping into anything too invasive or experimental. You are relatively early in your recovery, and this problem might still resolve itself spontaneously.

Your symptoms seem too limited to indicate widespread damage. I have problems with vision, memory, speech, seizures, balance, senses of smell, taste and touch, anger, anxiety, depression, focus, motor skills, etc..., etc..., etc...

As you say, these injuries are difficult to image. One of the best way to identify your deficits, and target your therapy/treatment, is to undergo a neuro-psych exam.

TBI can rob us of insight and self-awareness. That means that you could have problems you don't even recognize.

The over-stimulation is VERY common. I doubt a diagnosis if DAI vs simple concussion will change your treatment options. The treatment protocol is usually to treat the symptoms, not the diagnosis.

Lack of sleep can make over-stimulation more of a problem but many of us have over-stim problems even though we get adequate sleep.

Tinnitus is also a common symptom. I would be very hesitant to take on surgery for tinnitus unless there has been a solid diagnosis of an issue treatable by surgery. The side-effect risks from Microvascular decompression (MVD) surgery, also known as the Jannetta procedure, would have me very cautious before going under the knife.

As it's now nearly 4 months post accident I unfortunately consider the Tinnitus in my right ear to be permanent, and thus as Mark states, per doctors suggestion a possible Microvascular decompression surgery to see if a blood vessel might in fact be the culprit.

It seems Tinnitus is very common and painful permanent post concussive symptom. The only reason I'm open to a microvascular decompression is because my Tinnitus squeals with my heart beat and thus my hearing tests have been normal.

As Mark suggests perhaps more diagnosis should be suggested.

@ Hockey i'm so sorry to hear how bad your Tinnitus is. I'm in the same boat. Did the accident also impact your hearing levels?

Yes, I also suffer intermittent deafness. It happens several times a day, but usually only last a few moments. However, once I lost hearing in my right ear for five days - and started to wonder if it was ever coming back. The external tingling is annoying, the stabbing is horrendous and sometimes the pain is so bad that I can't even touch my ears.