Comparative Analysis on Traumatic Brain Injury Risk due to Primary and Secondary Impacts in a Vehicle-Pedestrian Sideswipe Accident

2016 ◽  
Author(s):  
Atsutaka Tamura ◽  
Junji Hasegawa ◽  
Takao Koide
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Risk ◽  
Velocity Change ◽  
Moving Vehicle ◽  
Point Potential ◽  
Regulatory Impact ◽  
Adult Head ◽  
Ground Impact ◽  
A Current

A series of vehicle-to-pedestrian sideswipe impacts were computationally reconstructed; a fast-walking pedestrian was collided laterally with the side of a moving vehicle at 25 or 40 km/h, which resulted in rotating the pedestrian’s body axially. Because of a limited interaction between the human body and striking vehicle, the struck pedestrian was projected transversely from the vehicle and fell to the ground close to the first impact point. Potential severity of traumatic brain injury (TBI) was assessed using linear and rotational acceleration pulses applied to the head and by measuring intracranial brain tissue deformation. We found that TBI risk due to a secondary head strike with the ground can be much greater than that due to a primary head strike with the vehicle. Further, an ‘effective’ head mass, meff, was computed based upon the impulse and velocity change involved in the secondary head strike, which mostly exceeded the mass of the adult head-form impactor (4.5 kg) commonly used for a current regulatory impact test for pedestrian safety assessment. Our results suggest that TBI risk due to a ground impact would be mitigated by actively controlling meff, because meff is closely associated with a pedestrian’s landing style in the final event of ground contact.

Comparative Analysis on Traumatic Brain Injury Risk Due to Primary and Secondary Impacts in a Pedestrian Sideswipe Accident

2018 ◽  
Vol 4 (4) ◽  
Author(s):  
Atsutaka Tamura ◽  
Junji Hasegawa ◽  
Takao Koide
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Risk ◽  
Rotational Acceleration ◽  
Velocity Change ◽  
Moving Vehicle ◽  
Acceleration Pulse ◽  
Regulatory Impact ◽  
Adult Head ◽  
The Moment

A series of pedestrian sideswipe impacts were computationally reconstructed; a fast-walking pedestrian was collided laterally with the side of a moving vehicle at 25 km/h or 40 km/h, which resulted in rotating the pedestrian's body axially. Potential severity of traumatic brain injury (TBI) was assessed using linear and rotational acceleration pulses applied to the head and by measuring intracranial brain tissue deformation. We found that TBI risk due to secondary head strike with the ground can be much greater than that due to primary head strike with the vehicle. Further, an “effective” head mass, meff, was computed based upon the impulse and vertical velocity change involved in the secondary head strike, which mostly exceeded the mass of the adult head-form impactor (4.5 kg) commonly used for a current regulatory impact test for pedestrian safety assessment. Our results demonstrated that a sport utility vehicle (SUV) is more aggressive than a sedan due to the differences in frontal shape. Additionally, it was highlighted that a striking vehicle velocity should be lower than 25 km/h at the moment of impact to exclude the potential risk of sustaining TBI, which would be mitigated by actively controlling meff, because meff is closely associated with a rotational acceleration pulse applied to the head involved in the final event of ground contact.

scholarly journals Influence of Skull Fracture on Traumatic Brain Injury Risk Induced by Blunt Impact

2020 ◽  
Vol 17 (7) ◽  
pp. 2392 ◽  
Author(s):  
Lihai Ren ◽  
Dangdang Wang ◽  
Xi Liu ◽  
Huili Yu ◽  
Chengyue Jiang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Risk ◽  
Skull Fracture ◽  
Human Model ◽  
Damage Modeling ◽  
Diffuse Brain Injury ◽  
Blunt Impact ◽  
Ground Impact ◽  
Diffuse Brain

This study is aimed at investigating the influence of skull fractures on traumatic brain injury induced by blunt impact via numerous studies of head–ground impacts. First, finite element (FE) damage modeling was implemented in the skull of the Total HUman Model for Safety (THUMS), and the skull fracture prediction performance was validated against a head–ground impact experiment. Then, the original head model of the THUMS was assigned as the control model without skull element damage modeling. Eighteen (18) head–ground impact models were established using these two FE head models, with three head impact locations (frontal, parietal, and occipital regions) and three impact velocities (25, 35, and 45 km/h). The predicted maximum principal strain and cumulative strain damage measure of the brain tissue were employed to evaluate the effect of skull fracture on the cerebral contusion and diffuse brain injury risks, respectively. Simulation results showed that the skull fracture could reduce the risk of diffuse brain injury risk under medium and high velocities significantly, while it could increase the risk of brain contusion under high-impact velocity.

scholarly journals Effects of Prescription Opioid Use on Traumatic Brain Injury Risk in Older Adults

2021 ◽  
Vol 36 (5) ◽  
pp. 388-395 ◽  
Author(s):  
Anthony V. Herrera ◽  
Linda Wastila ◽  
Jessica P. Brown ◽  
Hegang Chen ◽  
Steven R. Gambert ◽  
...  
Keyword(s):  
Older Adults ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Risk ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

A Numerical Study of Traumatic Brain Injury Due to Ground Impact in an SUV-Pedestrian Crash Using Full-Scale Finite Element Models

2010 ◽  
Author(s):  
Atsutaka Tamura
Keyword(s):  
Traumatic Brain Injury ◽  
Finite Element ◽  
Brain Injury ◽  
Numerical Study ◽  
Element Model ◽  
Whole Body ◽  
Impact Speed ◽  
Intrinsic Complexity ◽  
Pedestrian Crashes ◽  
Ground Impact

A number of studies have worked on traffic injuries or traumas related to pedestrian impacts. However, most of them placed more focuses on traumatic injuries due to primary impact with a striking vehicle rather than those involved in secondary impact with the ground. In this study, a validated, human whole-body, pedestrian finite element model was utilized to investigate the potential risk of traumatic brain injury (TBI) relevant to the ground impact as well as primary head strike in an SUV-to-pedestrian collision. By conducting a set of numerical experiments at impact speed of 25 and 40 km/h with pedestrian’s pre-impact, transverse, traveling speed of 1.3 m/s, it was found that ground impact is likely to cause serious TBI even in a low impact speed level. Although the post-impact kinematics and subsequent kinetics were considerably unpredictable due to the intrinsic complexity of pedestrian impact, this finding also suggests that impact speed does not necessarily contribute to the severity of pedestrian TBI involving vehicle with a higher profile. In the future, an effective countermeasure for ground impact should be taken into account to reduce the risk of sustaining serious TBIs in pedestrian crashes.

scholarly journals HEAD IMPACT SEVERITY MEASURES FOR EVALUATING MILD TRAUMATIC BRAIN INJURY RISK EXPOSURE

Neurosurgery ◽  
2008 ◽  
Vol 62 (4) ◽  
pp. 789-798 ◽  
Author(s):  
Richard M. Greenwald ◽  
Joseph T. Gwin ◽  
Jeffrey J. Chu ◽  
Joseph J. Crisco
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Injury Risk ◽  
Head Impact ◽  
Risk Exposure

scholarly journals Substance Use and Mild Traumatic Brain Injury Risk Reduction and Prevention: A Novel Model for Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jennifer H. Olson-Madden ◽  
Lisa A. Brenner ◽  
John D. Corrigan ◽  
Chad D. Emrick ◽  
Peter C. Britton
Keyword(s):  
Traumatic Brain Injury ◽  
Substance Use ◽  
Brain Injury ◽  
Drug Use ◽  
Risk Reduction ◽  
Risk Taking ◽  
Injury Risk ◽  
Risky Behaviors ◽  
Negative Outcomes ◽  
Risk Taking Behavior

Traumatic brain injury (TBI) and substance use disorders (SUDs) frequently co-occur. Individuals with histories of alcohol or other drug use are at greater risk for sustaining TBI, and individuals with TBI frequently misuse substances before and after injury. Further, a growing body of literature supports the relationship between comorbid histories of mild TBI (mTBI) and SUDs and negative outcomes. Alcohol and other drug use are strongly associated with risk taking. Disinhibition, impaired executive function, and/or impulsivity as a result of mTBI also contribute to an individual’s proclivity towards risk-taking. Risk-taking behavior may therefore, be a direct result of SUD and/or history of mTBI, and risky behaviors may predispose individuals for subsequent injury or continued use of substances. Based on these findings, evaluation of risk-taking behavior associated with the co-occurrence of SUD and mTBI should be a standard clinical practice. Interventions aimed at reducing risky behavior among members of this population may assist in decreasing negative outcomes. A novel intervention (Substance Use and Traumatic Brain Injury Risk Reduction and Prevention (STRRP)) for reducing and preventing risky behaviors among individuals with co-occurring mTBI and SUD is presented. Areas for further research are discussed.

scholarly journals A Biomechanical Evaluation of a Novel Airbag Bicycle Helmet Concept for Traumatic Brain Injury Mitigation

2021 ◽  
Vol 8 (11) ◽  
pp. 173
Author(s):  
Kwong Ming Tse ◽  
Daniel Holder
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Risk ◽  
Synergetic Effect ◽  
Human Head ◽  
Head Model ◽  
Bicycle Helmet ◽  
Impact Simulations ◽  
The Impact ◽  
Helmet Design

In this study, a novel expandable bicycle helmet, which integrates an airbag system into the conventional helmet design, was proposed to explore the potential synergetic effect of an expandable airbag and a standard commuter-type EPS helmet. The traumatic brain injury mitigation performance of the proposed expandable helmet was evaluated against that of a typical traditional bicycle helmet. A series of dynamic impact simulations on both a helmeted headform and a representative human head with different configurations were carried out in accordance with the widely recognised international bicycle helmet test standards. The impact simulations were initially performed on a ballast headform for validation and benchmarking purposes, while the subsequent ones on a biofidelic human head model were used for assessing any potential intracranial injury. It was found that the proposed expandable helmet performed admirably better when compared to a conventional helmet design—showing improvements in impact energy attenuation, as well as kinematic and biometric injury risk reduction. More importantly, this expandable helmet concept, integrating the airbag system in the conventional design, offers adequate protection to the cyclist in the unlikely case of airbag deployment failure.

scholarly journals MON-370 Treatment of Parathyroid Storm in a Patient with Traumatic Brain Injury: A Reversible Comatose State

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jane Rhyu ◽  
Jeffrey Wei ◽  
Christine Hema Darwin
Keyword(s):  
Traumatic Brain Injury ◽  
Acute Kidney Injury ◽  
Brain Injury ◽  
Mental Status ◽  
Injury Risk ◽  
Clavicle Fracture ◽  
Kidney Injury ◽  
Cystic Degeneration ◽  
Severe Hypercalcemia ◽  
Comatose State

Abstract Background: Parathyroid storm, also known as parathyroid crisis, is a rare and under-recognized endocrine emergency due to severe hypercalcemia in patients with primary hyperparathyroidism. It is characterized by significantly elevated parathyroid hormone (PTH) levels even up to 20 times above the normal limit along with calcium levels >15 mg/dl, leading to multiorgan dysfunction, notably altered mental status and acute kidney injury. Risk of mortality is high without urgent parathyroidectomy. We describe a case of a patient with acute traumatic brain injury and parathyroid storm with PTH >1700 pg/ml (11-51) and Ca 15.4 mg/dl (8.6-10.4) in whom resection of a parathyroid adenoma reversed the comatose state. Clinical Case: Our patient is a 68 year-old male with no significant past medical history who sustained a fall off a 12-foot ladder complicated by right intracranial bleed s/p hemicraniectomy and multiple fractures, including left clavicle fracture with possible subclavian artery injury, left rib fractures, and right hip fracture s/p ORIF. The patient had a brief, partial improvement of mental status, followed by comatose state in the setting of rapidly rising calcium levels and acute kidney injury. In the setting of blood transfusions, the patient had an initial Ca of 8.8 mg/dl (8.6-10.4) on admission. The calcium levels rose over a week to 15.4 mg/dl with albumin of 2.4 g/dl (3.9-5.0), PTH levels from 953 pg/ml to >1700 pg/ml (11-51) after tracheostomy, and creatinine from 0.69 mg/dl to peak of 2.0 mg/dl (0.60-1.30). In spite of IV hydration, calcitonin, cinacalcet up to 90mg twice daily, pamidronate 60mg IV, and several sessions of hemodialysis, the patient’s calcium did not normalize, and the patient remained comatose. Other labs showed phosphorus nadir of 1.4 mg/dl (2.3-4.4), 25-OH VitD 13 ng/ml (20-50), 1,25-OH VitD 9.8 pg/ml (19.9-79.3), VitA 0.6 mg/L (0.3-0.9), PTHrP <2.0 pmol/L (0.0-2.3), normal SPEP/UPEP, and peak CK of 569 U/L (63-474). Sestamibi scan showed intense tracer uptake within a nodule near the suprasternal notch, and parathyroid 4D-CT showed a left 17mm pretracheal lesion with cystic degeneration along the superior margin of the manubrium. The patient subsequently underwent parathyroidectomy of an ectopic cystic mass with normalization of calcium and PTH levels. Pathology revealed a 0.8 gram, 1.5 x 1.0 x 0.3 cm enlarged, hypercellular parathyroid. The patient woke up from his comatose state immediately after surgery with progressive improvement in mental status back to baseline, other than left-sided weakness. Conclusion: Our case highlights the importance of surgical management as an effective cure for parathyroid crisis and underscores the associated critical and significant rise in calcium and PTH levels, which was resistant to medical treatment.

Assessment of standing passenger traumatic brain injury caused by ground impact in subway collisions

2022 ◽  
Vol 166 ◽  
pp. 106547
Author(s):  
Gongxun Deng ◽  
Fang Wang ◽  
Chao Yu ◽  
Yong Peng ◽  
Hongzhen Xu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ground Impact
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