Relation Between Diffuse Axonal Injury and Internal Head Structures on Blunt Impact

1998 ◽  
Vol 120 (1) ◽  
pp. 140-147 ◽  
Author(s):  
T. Nishimoto ◽  
S. Murakami

Diffuse axonal injury (DAI) is a severe head injury, which exhibits symptoms of consciousness disturbance and is thought to occur through rotational angular acceleration. This paper analyzes the occurrence of DAI when direct impacts with translational accelerations are applied to two-dimensional head models. We constructed a human model reproducing the human head structure, as well as modified human models with some internal head structures removed. Blunt direct impacts were applied from a lateral direction to the bottom of the third ventricle, considered to be the center of impact, using an impactor. The analysis was done by comparing the macroscopic manifestation of DAI with the shear stress as the engineering index. In the analytical data obtained from the human model, shear stresses were concentrated on the corpus callosum and the brain stem, in the deep area. This agrees with regions of the DAI indicated by small hemorrhages in the corpus callosum and the brain stem. The analytical data obtained by the modified human models show that the high shear stress on the corpus callosum is influenced by the falx cerebri, while the high shear stress on the brain stem is influenced by the tentorium cerebelli and the shape of the brain. These results indicate that DAI, generally considered to be influenced by angular acceleration, may also occur through direct impact with translational acceleration. We deduced that the injury mechanism of DAI is related to the concentration of shear stress on the core of the brain, since the internal head structures influence the impact stress concentration.

2019 ◽  
Vol 17 (07) ◽  
pp. 1950029 ◽  
Author(s):  
Lihai Ren ◽  
Dangdang Wang ◽  
Chengyue Jiang ◽  
Yuanzhi Hu

The biofidelity is an essential requirement of the application of human head finite element (FE) models to investigate head injuries under mechanical loadings. However, the influence of the foramen magnum boundary condition (FMBC) on intracranial dynamic responses under head impacts has yet to be fully identified until now. This study aimed to investigate the effect of different modeling methods of the FMBC on intracranial dynamic responses induced by forehead impact, especially the axonal injury associated dynamic responses. The total human model for safety (THUMS) was applied in this study. Two FE models with different FMBC modeling methods were developed from the THUMS model. Then, three forehead impact FE models were established respectively, including the original THUMS model. Further FE simulations were conducted to investigate the influence of FMBC modeling methods on intracranial dynamic responses. Though, difference between the intracranial dynamic responses (relative skull-brain motion and strain responses) at areas far from the foramen magnum were slightly, the corresponding difference at the brain stem area were distinctly. Meanwhile, the predicted axonal injury risk of the brain stem white matter was varying among each other. Different modeling methods of FMBC could result in different intracranial dynamic responses of the brain stem, and affect the axonal injury prediction. Therefore, the modeling of the FMBC should be further evaluated for the study of brain stem injury using human head FE models.


Medicine ◽  
2019 ◽  
Vol 98 (41) ◽  
pp. e17467 ◽  
Author(s):  
Sung Ho Jang ◽  
Oh Lyong Kim ◽  
Seong Ho Kim ◽  
Han Do Lee

2011 ◽  
Vol 153 (8) ◽  
pp. 1687-1694 ◽  
Author(s):  
Hidetoshi Matsukawa ◽  
Masaki Shinoda ◽  
Motoharu Fujii ◽  
Osamu Takahashi ◽  
Daisuke Yamamoto ◽  
...  

Author(s):  
Jean-Pierre Dollé ◽  
Jeffrey Barminko ◽  
Rene Schloss ◽  
Martin L. Yarmush

Traumatic Brain Injuries (TBI) affect up to 1.5 million people annually within the United States with as many as 250,000 being hospitalized and 50,000 dying [1]. TBI events occur when the brain experiences a sudden trauma such as a rapid deceleration of the brain that typically occurs during motor vehicle accidents. During rapid deceleration events, the brain is subjected to high inertial forces that can result in a shearing or elongation of axons that is commonly known as Diffuse Axonal Injury (DAI) [2,3].


2016 ◽  
Vol 28 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Shiho Ubukata ◽  
Keita Ueda ◽  
Genichi Sugihara ◽  
Walid Yassin ◽  
Toshihiko Aso ◽  
...  

Author(s):  
Meaghan Wunder ◽  
Kara Ruicci

Diffuse axonal injury is one of the most common and debilitating pathologies resulting from mechanical deformation of the brain.  The current case involves a 19-year-old female involved in a high velocity ski crash. The accident resulted in a right lower leg fracture, with no loss of consciousness or evidence of head trauma.  Approximately 6.5 hours after her admission, the neurological status of the patient deteriorated markedly, and magnetic resonance imaging findings were consistent with diffuse axonal injury.  This presentation illustrates a case of delayed diffuse axonal injury, a phenomenon not commonly described.  Diffuse axonal injury involves rapid inertial forces causing strain to brain tissue.  This strain results in various stages of diffuse axonal damage and inflammation.  This article highlights a case of delayed onset diffuse axonal injury, describes the progression of neural sequelae post-injury resulting in axonal damage and explores proposed therapeutic targets. 


2020 ◽  
Vol 11 (Vol.11, no.3) ◽  
pp. 368-371
Author(s):  
Corina ROMAN-FILIP ◽  
Maria-Gabriela CATANĂ

Noticeable advances have occurred in the field of traumatic brain injury in the past ten years. Brain imagery provides a more precise representation of what occurs in the brain, diffuse axonal injury being an important cause of morbidity and mortality in patients with traumatic brain injury. We present 2 cases that were admitted and discharged from our department. Actually we want to emphasize differences and similarities between the two cases and to highlight different sequelae that traumatic brain injury can do in young patients. Both patients were admitted in a critical state – GCS 4 points and were discharged with an improved neurological status after approximately 30 days. We decided to present these cases to issue a warning about the rehabilitation for these patients which most of the times have a prolonged hospitalization. We wanted to highlight that the rehabilitation does not consist only in the motor part, but in the psychiatric and behaviour part too.


2018 ◽  
Vol 140 (8) ◽  
Author(s):  
Soroush Heidari Pahlavian ◽  
John Oshinski ◽  
Xiaodong Zhong ◽  
Francis Loth ◽  
Rouzbeh Amini

Intrinsic cardiac-induced deformation of brain tissue is thought to be important in the pathophysiology of various neurological disorders. In this study, we evaluated the feasibility of utilizing displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) to quantify two-dimensional (2D) neural tissue strain using cardiac-driven brain pulsations. We examined eight adult healthy volunteers with an electrocardiogram-gated spiral DENSE sequence performed at the midsagittal plane on a 3 Tesla MRI scanner. Displacement, pixel-wise trajectories, and principal strains were determined in seven regions of interest (ROI): the brain stem, cerebellum, corpus callosum, and four cerebral lobes. Quantification of small neural tissue motion and strain along with their spatial and temporal variations in different brain regions was found to be feasible using DENSE. The medial and inferior brain structures (brain stem, cerebellum, and corpus callosum) had significantly larger motion and strain compared to structures located more peripherally. The brain stem had the largest peak mean displacement (PMD) (187 ± 50 μm, mean ± SD). The largest mean principal strains in compression and extension were observed in the brain stem (0.38 ± 0.08%) and the corpus callosum (0.37 ± 0.08%), respectively. Measured values in percent strain were altered by as much as 0.1 between repeated scans. This study showed that DENSE can quantify regional variations in brain tissue motion and strain and has the potential to be utilized as a tool to evaluate the changes in brain tissue dynamics resulting from alterations in biomechanical stresses and tissue properties.


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