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A 28-Year-Old Man Is Evaluated After a High-Speed Motorcycle Collision

Question 163

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A 28-year-old man is evaluated after a high-speed motorcycle collision.He is in an unresponsive state after being involved in a motor vehicle accident. A CT scan of the head showed no abnormalities. He dies despite proper treatment. His medical history is unavailable. Brain autopsy examination shows widespread axonal swelling, predominantly at the gray-white junction.  Immunohistochemical staining of these axons reveals accumulation of alpha-synuclein and amyloid precursor proteins.  Which of the following is the most likely cause of these observed findings?


A) Diffuse cerebral hypoperfusion
B) Disruption of the bridging cortical veins
C) Glutamate-mediated neuronal injury
D) Interruption of the white matter tracts
E) Secondary microvascular spasm

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