Adams DAI grades

Diffuse Axonal Injury

Grade I

involves grey-white matter interfaces
  • most commonly : parasagittal regions of frontal lobes, periventricular temporal lobes
  • less commonly : parietal and occipital lobes, internal and external capsules, and cerebellum
  • often inapparent on conventional imaging
  • may have changes on Magnetic Resonance Spectroscopy
  • Grade II

    involves corpus callosum in addition to stage I locations
  • observed in approximately 20% of patients
  • most commonly : posterior body and splenium but does advance anteriorly with increasing severity of injury
  • most frequently unilateral
  • may be seen on Susceptibility Weighted Imaging
  • Grade III

    involves brainstem in addition to stage I and II locations
  • most commonly : rostral midbrain, superior cerebellar peduncles, medial lemnisci and corticospinal tracts
  • Reference