Child ATD Reconstruction of a Fatal Pediatric Fall

2009 ◽  
Author(s):  
Chris Van Ee ◽  
David Raymond ◽  
Kirk Thibault ◽  
Warren Hardy ◽  
John Plunkett
Keyword(s):  
Head Injury ◽  
Additional Data ◽  
Skull Fracture ◽  
Angular Acceleration ◽  
Linear Acceleration ◽  
Test Device ◽  
Critical Data ◽  
Animal Data ◽  
Injury Assessment ◽  
Accident Scenarios

The current head Injury Assessment Reference Values (IARVs) for the child dummies are based in part on scaling adult and animal data and on reconstructions of real world accident scenarios. Reconstruction of well-documented accident scenarios provides critical data in the evaluation of proposed IARV values, but relatively few accidents are sufficiently documented to allow for accurate reconstructions. This reconstruction of a well documented fatal-fall involving a 23-month old child supplies additional data for IARV assessment. The videotaped fatal-fall resulted in a frontal head impact onto a carpet-covered cement floor. The child suffered an acute right temporal parietal subdural hematoma without skull fracture. The fall dynamics were reconstructed in the laboratory and the head linear and angular accelerations were quantified using the CRABI-18 Anthropomorphic Test Device (ATD). Peak linear acceleration was 125 ± 7 g (range 114–139), HIC15 was 335 ± 115 (Range 257–616), peak angular velocity was 57± 16 (Range 26–74), and peak angular acceleration was 32 ± 12 krad/s2 (Range 15–56). The results of the CRABI-18 fatal fall reconstruction were consistent with the linear and rotational tolerances reported in the literature. This study investigates the usefulness of the CRABI-18 anthropomorphic testing device in forensic investigations of child head injury and aids in the evaluation of proposed IARVs for head injury.

Evaluation and Refinement of the CRABI-6 Anthropomorphic Test Device Injury Criteria for Skull Fracture

2009 ◽  
Author(s):  
Chris Van Ee ◽  
Barbara Moroski-Browne ◽  
David Raymond ◽  
Kirk Thibault ◽  
Warren Hardy ◽  
...  
Keyword(s):  
Head Injury ◽  
Reference Values ◽  
Head Injuries ◽  
Skull Fracture ◽  
Linear Acceleration ◽  
Free Fall ◽  
Head Acceleration ◽  
Test Device ◽  
Impact Surface ◽  
Injury Criteria

Only sparse experimental pediatric tissue tolerance data are available for the development of pediatric surrogates and associated injury reference values. The objective of this study is to improve the efficacy of the CRABI series anthropometric test devices by increasing the foundational data used for head injury and skull fracture. To accomplish this, this study evaluated and refined the CRABI-6 injury assessment reference values (IARV) associated with skull fracture by correlating the test device response with the detailed fracture results of 50 infant cadaver drop studies reported by Weber in 1984 and 1985. Using the CRABI-6 test device, four 82-cm height free fall impacts were performed onto each of four different impact surfaces: concrete, carpet, 2-cm foam mat, and an 8-cm thick camel hair blanket. Average and standard deviation of peak head linear acceleration and HIC36 (Head Injury Criteria) were computed for each impact surface. The average CRABI impact response was mapped to the Weber fracture outcomes for corresponding impact surfaces and logistic regression was performed to define a skull fracture risk curve based on exposure. The 5%, 25%, 50%, 75%, and 95% risk for skull fracture correlated with a CRABI-6 peak linear head acceleration of 50, 70, 82, 94, and 114 g’s and a HIC36 of 87, 214, 290, 366 and 493, respectively. This study made use of the most extensive set of controlled infant cadaver head impact and fracture data currently available. Previous head IARVs for the CRABI-6 are given by Melvin (1995) and by Klinich et al. (2002). Based on a review of pediatric tissue experiments, scaling of adult and child dummy IARVs, and sled tests, Melvin suggested a HIC22 of 390 and a limit on peak head acceleration of 50 g’s. Klinich et al. reported the results of three reconstructions of airbag-related infant head injuries and three additional reconstructions not associated with head injury. They estimated the 50% risk of minor skull fracture to be 85 g’s and 220 HIC15. These previously reported estimates appear to be in agreement with the results reported from this study for CRABI-6 IARV of 50% risk of skull fracture at 82 g’s and 290 HIC36.

scholarly journals Brain injury in sports

2016 ◽  
Vol 124 (3) ◽  
pp. 667-674 ◽  
Author(s):  
John Lloyd ◽  
Frank Conidi
Keyword(s):  
Brain Injuries ◽  
Scientific Evidence ◽  
Head Injuries ◽  
Skull Fracture ◽  
Angular Acceleration ◽  
Linear Acceleration ◽  
Impact Testing ◽  
Common Belief ◽  
Percentage Reduction ◽  
Football Helmets

OBJECT Helmets are used for sports, military, and transportation to protect against impact forces and associated injuries. The common belief among end users is that the helmet protects the whole head, including the brain. However, current consensus among biomechanists and sports neurologists indicates that helmets do not provide significant protection against concussion and brain injuries. In this paper the authors present existing scientific evidence on the mechanisms underlying traumatic head and brain injuries, along with a biomechanical evaluation of 21 current and retired football helmets. METHODS The National Operating Committee on Standards for Athletic Equipment (NOCSAE) standard test apparatus was modified and validated for impact testing of protective headwear to include the measurement of both linear and angular kinematics. From a drop height of 2.0 m onto a flat steel anvil, each football helmet was impacted 5 times in the occipital area. RESULTS Skull fracture risk was determined for each of the current varsity football helmets by calculating the percentage reduction in linear acceleration relative to a 140-g skull fracture threshold. Risk of subdural hematoma was determined by calculating the percentage reduction in angular acceleration relative to the bridging vein failure threshold, computed as a function of impact duration. Ranking the helmets according to their performance under these criteria, the authors determined that the Schutt Vengeance performed the best overall. CONCLUSIONS The study findings demonstrated that not all football helmets provide equal or adequate protection against either focal head injuries or traumatic brain injuries. In fact, some of the most popular helmets on the field ranked among the worst. While protection is improving, none of the current or retired varsity football helmets can provide absolute protection against brain injuries, including concussions and subdural hematomas. To maximize protection against head and brain injuries for football players of all ages, the authors propose thresholds for all sports helmets based on a peak linear acceleration no greater than 90 g and a peak angular acceleration not exceeding 1700 rad/sec2.

scholarly journals Impact test comparisons of 20th and 21st century American football helmets

2012 ◽  
Vol 116 (1) ◽  
pp. 222-233 ◽  
Author(s):  
Adam Bartsch ◽  
Edward Benzel ◽  
Vincent Miele ◽  
Vikas Prakash
Keyword(s):  
Head Injury ◽  
21St Century ◽  
Injury Risk ◽  
Diffuse Axonal Injury ◽  
Angular Acceleration ◽  
Linear Acceleration ◽  
Severity Index ◽  
Head Impact ◽  
American Football ◽  
Acute Subdural Hematoma

Object Concussion is the signature American football injury of the 21st century. Modern varsity helmets, as compared with vintage leather helmets, or “leatherheads,” are widely believed to universally improve protection by reducing head impact doses and head injury risk for the 3 million young football players in the US. The object of this study was to compare the head impact doses and injury risks with 11 widely used 21st century varsity helmets and 2 early 20th century leatherheads and to hypothesize what the results might mean for children wearing similar varsity helmets. Methods In an injury biomechanics laboratory, the authors conducted front, oblique front, lateral, oblique rear, and rear head impact tests at 5.0 m/second using helmeted headforms, inducing near- and subconcussive head impact doses on par with approximately the 95th percentile of on-field collision severity. They also calculated impact dose injury risk parameters common to laboratory and on-field traumatic neuromechanics: linear acceleration, angular acceleration, angular velocity, Gadd Severity Index, diffuse axonal injury, acute subdural hematoma, and brain contusion. Results In many instances the head impact doses and head injury risks while wearing vintage leatherheads were comparable to or better than those while wearing several widely used 21st century varsity helmets. Conclusions The authors do not advocate reverting to leather headgear, but they do strongly recommend, especially for young players, instituting helmet safety designs and testing standards, which encourage the minimization of linear and angular impact doses and injury risks in near- and subconcussive head impacts.

Evaluating the Performance of a Hockey Helmet in Mitigating Concussion Risk Using Measures of Acceleration and Energy During Simulated Free Fall

2021 ◽  
Vol 3 (2) ◽  
pp. 33-50
Author(s):  
Carlos Zerpa ◽  
Stephen Carlson ◽  
Eryk Przysucha ◽  
Meilan Liu ◽  
Paolo Sanzo
Keyword(s):  
Head Injury ◽  
Skull Fracture ◽  
Linear Acceleration ◽  
Free Fall ◽  
Impact Angle ◽  
Impact Factors ◽  
Neck Stiffness ◽  
Risk Of Injury ◽  
Head Protection ◽  
Testing Protocols

Hockey helmets represent the best form of head protection available to reduce the occurrence of skull fracture and concussion. Currently, helmet testing protocols focus on the reduction of peak linear acceleration measures. Gaps exist in analyzing how certain impact factors such as angle, neck stiffness, and location influence the energy loaded to the helmet and the risk of injury during head collisions. This study examined the effect of helmet impact angle, neck stiffness-torque levels, and helmet impact locations on energy reduction and risk of head injury grounded on acceleration measures using simulated free fall head collisions. The researchers conducted 540 impacts to collect the data. The results revealed statistical interaction effects between the angle of impact and location on measures of energy and risk of head injury. This study builds on existing literature by introducing an energy measurement technique to assess helmet performance. The outcome also provides an avenue for helmet manufacturers to evaluate the performance of the helmet in reducing concussion risk.

Risk assessment in different Judo techniques for children and adolescent athletes

2020 ◽  
Vol 234 (7) ◽  
pp. 686-696
Author(s):  
Luca Vacca ◽  
Valeria Rosso ◽  
Laura Gastaldi
Keyword(s):  
Head Injury ◽  
Injury Risk ◽  
Inertial Sensors ◽  
Angular Acceleration ◽  
Linear Acceleration ◽  
Severity Index ◽  
Time Duration ◽  
Neck Extension ◽  
Children And Adolescent ◽  
Experience Levels

Judo is a combat sport that involves throwing the opponent onto the back. When being thrown, head biomechanics may be related to head injury risk. This study aimed to assess head injury risks associated with four Judo techniques in children and adolescents with different experience levels. Twenty children (<12 years) and 20 adolescents (≥ 12 years) judoka were recruited. Each group was divided into non-expert and expert. Two inertial sensors were fixed on fallers’ head and torso. Two backward ( o-soto-gari and o-uchi-gari) and two forward ( ippon-seoi-nage and tai-otoshi) techniques were performed. Peak of linear and angular head acceleration magnitude, impact time duration, neck angle, and the Gadd Severity Index were assessed. Children did not show differences between techniques or experience levels. In contrast, adolescents showed greater linear acceleration peak in o-soto-gari than tai-otoshi (p = 0.03), greater angular acceleration peak in o-soto-gari and o-uchi-gari than ippon-seoi-nage (p < 0.05), and greater neck flexion in o-uchi-gari than ippon-seoi-nage (p = 0.004). Compared to expert adolescents, non-expert adolescents showed greater angular acceleration peak, impact duration, and the Gadd Severity Index in o-soto-gari (p < 0.05) and greater neck extension in o-uchi-gari (p = 0.02). Current results pointed out higher risks for adolescents judoka while being thrown with backward techniques, especially for non-expert participants. This study highlights the need of training athletes in controlling head and neck during back falls from a young age to become expert judoka in adulthood.

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

Laboratory and field evaluation of a small form factor head impact sensor in un-helmeted play

2017 ◽  
Vol 232 (3) ◽  
pp. 242-254 ◽  
Author(s):  
Derek Nevins ◽  
Kasee Hildenbrand ◽  
Jeff Kensrud ◽  
Anita Vasavada ◽  
Lloyd Smith
Keyword(s):  
Form Factor ◽  
Center Of Mass ◽  
False Negative ◽  
Angular Acceleration ◽  
Linear Acceleration ◽  
Field Evaluation ◽  
Head Impact ◽  
Sensor Data ◽  
Small Form ◽  
Small Form Factor

Head impact sensors are increasingly used to quantify the frequency and magnitude of head impacts in sports. A dearth of information exists regarding head impact in un-helmeted sport, despite the substantial number of concussions experienced in these sports. This study evaluated the performance of one small form factor head impact sensor in both laboratory and field environments. In laboratory tests, sensor performance was assessed using a Hybrid III headform and neck. The headform assembly was mounted on a low-friction sled and impacted with three sports balls over a range of velocities (10–31 m/s) at two locations and from three directions. Measures of linear and angular acceleration obtained from the small form factor wireless sensor were compared to measures of linear and angular acceleration obtained by wired sensors mounted at the headform center of mass. Accuracy of the sensor varied inversely with impact magnitude, with relative differences across test conditions ranging from 0.1% to 266.0% for peak linear acceleration and 4.7% to 94.6% for peak angular acceleration when compared to a wired reference system. In the field evaluation, eight male high school soccer players were instrumented with the head impact sensor in seven games. Video of the games was synchronized with sensor data and reviewed to determine the number of false positive and false negative head acceleration event classifications. Of the 98 events classified as valid by the sensor, 20.5% (20 impacts) did not result from contact with the ball, another player, the ground or player motion and were therefore considered false positives. Video review of events classified as invalid or spurious by the sensor found 77.8% (14 of 18 impacts) to be due to contact with the ball, another player or player motion and were considered false negatives.

A case of contrecoup skull fracture caused by mild head injury

2014 ◽  
Vol 125 ◽  
pp. 106-108 ◽  
Author(s):  
Shoko Merrit Yamada ◽  
Yoshiro Takaoka ◽  
Hiroshi Matsuura
Keyword(s):  
Head Injury ◽  
Skull Fracture ◽  
Mild Head Injury

scholarly journals Development of Head Injury Assessment Reference Values Based on NASA Injury Modeling

2011 ◽  
Author(s):  
Jeffrey T. Somers ◽  
Bradley Granderson ◽  
John W. Melvin ◽  
Ala Tabiei ◽  
Charles Lawrence ◽  
...  
Keyword(s):  
Head Injury ◽  
Reference Values ◽  
Injury Assessment

scholarly journals PENGARUH PEMBERIAN OKSIGEN DAN ELEVASI KEPALA 30º TERHADAP TINGKAT KESADARAN PADA PASIEN CEDERA KEPALA SEDANG

2020 ◽  
Vol 2 (2) ◽  
pp. 102-112
Author(s):  
Luci Riani Ginting ◽  
Kuat Sitepu ◽  
Renni Ariana Ginting
Keyword(s):  
Head Injury ◽  
Skull Fracture ◽  
P Value ◽  
Average Value ◽  
Level Of Consciousness ◽  
Before And After ◽  
Quasi Experimental ◽  
Oxygen Perfusion ◽  
The Brain ◽  
Adequate Oxygenation

Head injury is directly or indirectly mechanical injuries that resulted wound in the scalp, skull fracture, tear the lining of the brain, and brain damage, and neurological disorders. The basic method for brain protection of head injury patients are freeing the airway and giving adequate oxygenation. Giving oxygen and headv elevation 30° of head are the appropriate action for the moderate head injury classification to launch the cerebral oxygen perfusion and to increase consciousness level. The purpose of this research were to determine the GCS before and after giving oxygenation with and position 30 ° of head and to analyze the effect of giving oxygen and headv elevation30 °of head to change the levels of consciousness of moderate head injury patients. This research was an Quasi-Experimental study with 10 respondents. The test were used Paired Sample T-test Test. The results showed that there was an effect of giving oxygen and headv elevation 30 °of head toward to change the level of consciousness of moderate head injury patients. GCS average value before was 10.10 and GCS average after 12.90 value was with p value was 0.000. Keywords : Levels of Consciousness GCS, Moderate Head Injury, Position 30° of the Head

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