PATOFISIOLOGI DAN TERAPI DIFFUSE AXONAL INJURY PADATRAUMA KAPITIS

Diffuse axonal injury (DAI) Is an Injury mechanism that predominates in head trauma and results in a quite high mortality, disability, and their treatment cost. The pathophysiological process of DAI includes primary axotomy, secondary axotomy and Wallerlan degeneration. Primary axotomy begins when axons experiencing strain injury of e" 65%. Secondary axotomy begins when axons experienc- .ingstrain Injury of 5-10%. Secondary axotomy covers calcium Influx resulting in calpain, caspase and calcineurln activation, followed by cytosceletal degradation, and continued with two forms ofaxons transection disorder which are Impaired axonal transport (IAT) pathway, results in disconnected axon ends forming a retraction ball, and neurofllament compaction (NFC) pathway, results in disconnected axon ends in linear shape. Wallerlan degeneration ends the DAI pathophysiological process with removing axon and myelin debris by macrophages In distal side of transected axons. The studies of DAI therapy based on the effect of medication In the early pathophysiological process of DAI with