Introduction: Traumatic brain injury is an insult to the brain parenchyma, which is not degenerative or congenital and involves external forces; it is accompanied by changes in the transient or permanent memory, psychological and functional features, and altered consciousness. The diffuse axonal injury is frequent in the TBI, which sometimes leads to coma and eventually to permanent disability or death of the patient. Case report: A 17-year-old male suffered motorcycle accident. He presented to hospital with clinically poor general conditions. We proceeded to advanced airway management; endopleural tube was placed due to right pneumothorax. Surgery was performed 24 hours later finding hemoperitoneum, splenic trauma grade IV, hepatic trauma grade II, trauma transverse colon and two nonprogressive retroperitoneal hematoma. He was transferred to ICU under mechanical ventilatory assistance, hemodynamically prone to hypotension, sedation due to brain trauma and cerebral edema. Laboratory results reported anemia and leukocytosis. Gasometrical analytics showed compensated respiratory acidosis. Head CT showed the presence of bilateral maxillary hemoseno, ethmoid and sphenoid, severe cerebral edema. Subarachnoid hemorrhage on the interhemispheric fissure, and multiples hypodensities. It was diagnosed with severe brain injury, diffuse axonal injury (DAI), frontal hemorrhage and hypoxic encephalopathy. The expected outcome is an evolution to persistent vegetative state. Conclusion: Patients suffering DAI post TBI should be evaluated early to carry out the correct therapeutic measures and thus reduce neurological sequelae.
