An 11-year-old boy was involved in a car accident and presented in a semicomatous state.
Clinically he was diagnosed as having sustained a diffuse axonal injury and was treated conservatively.
A brain MRI was performed one month following injury and a repeat one 1 year later.
Susceptibility WI at the one month interval showed multiple microhemorrhages in both frontal lobes.
The one year follow-up MRI showed diffuse, symmetric, confluent hyperintensities in the periventricular WM and these findings were not present on the initial MRI.
The question is whether the WM changes seen at the one-year follow up study are related to the diffuse axonal injury. The microbleeds seen on SWI did not coincide exactly with the WM changes.
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