A Finite Element Model for Estimating Axonal Damage in Traumatic Brain Injury

Author(s):  
Rika M. Wright ◽  
K. T. Ramesh

There has been an ongoing effort to reduce the occurrence of sports-related traumatic brain injury. These injuries are caused by an impact to the head and often lead to the damage of neural axons in the brain. This type of damage is classified as diffuse axonal injury (DAI) or traumatic axonal injury (TAI) [1]. One of the difficulties in studying the progression of axonal injury is that the structural signature of DAI cannot be readily visualized with conventional medical imaging modalities since the damage occurs at the cellular level [2]. This also makes the injury difficult to diagnose. Many researchers have turned to finite element (FE) models to study the development of diffuse axonal injury. FE models provide a means for observing the mechanical process of injury development from the loads to the head at the macroscale to the damage that results at the cellular level. However, for a finite element model to be a viable tool for studying DAI, the model must be able to accurately represent the behavior of the brain tissue, and it must be able to accurately predict injury. In this work, we address both of these issues in an effort to improve the material models and injury criteria used in current FE models of TBI. We represent the white matter with an anisotropic, hyper-viscoelastic constitutive model, incorporate the microstructure of the white matter through the use of diffusion tensor imaging (DTI), and estimate injury using an axonal strain injury (ASI) criterion (Figure 1). We also develop a novel method to quantify the degree of axonal damage in the fiber tracts of the brain.

2021 ◽  
pp. 60-61
Author(s):  
Sumit Baviskar ◽  
Sneha Mote ◽  
Vishakha Gajre ◽  
Azhar Patwe

INTRODUCTION: Diffuse axonal injury (DAI) is a relatively less common but severe form of traumatic brain injury. It occurs due to shearing forces and is identied as one of the most important causes of morbidity and mortality in patients with traumatic brain injury. MRI is found to be diagnostic when CTndings are normal and there are persistent unexplained neurologic ndings or at subacute and chronic periods. AIM: To evaluate the role of MRI in the diagnosis of diffuse axonal injury. MATERIALAND METHODS: 9 Subjects were identied retrospectively with the diagnosis of DAI on MRI in last 2 years. The 1.5TMRI scans of the patients with DAI included: T1 and T2- weighted imaging, FLAIR imaging and T2*-weighted gradient echo (GRE) imaging. Lesions were identied and compared on all sequences. RESULTS: The lesions were in cerebral white matter location in the cases of mild DAI, whereas in the severe DAI located in basal ganglia, corpus callosum, dorsal part of the brain stem as well as the cerebral white matter. For Haemorrhagic lesions, GRE is the best tool to detect haemorrhagic DAIs. For Non-haemorrhagic lesion, FLAIR and DWI are the best current tool to detect small and non-haemorrhagic parenchymal lesions, displayed as hyperintense lesions.


Author(s):  
Rika M. Wright ◽  
K. T. Ramesh

With the increase in the number of soldiers sustaining traumatic brain injury from military incidents and the recent attention on sports related traumatic brain injury, there has been a focused effort to develop preventative and treatment methods for traumatic brain injury (TBI). Traumatic brain injury is caused by mechanical loading to the head, such as from impacts, sudden accelerations, or blast loading, and the pathology can range from focal damage in the brain to widespread diffuse injury [1]. In this study, we investigate the injury mechanisms of diffuse axonal injury (DAI), which accounts for the second largest percentage of deaths due to brain trauma [2]. DAI is caused by sudden inertial loads to the head, and it is characterized by damage to neural axons. Despite the extensive research on DAI, the coupling between the mechanical loading to the head and the damage at the cellular level is still poorly understood. Unlike previous computational models that use macroscopic stress and strain measures to determine injury, a cellular injury criterion is used in this work as numerous studies have shown that cellular strain can be related to the functional damage of neurons. The effectiveness of using this cellular injury criterion to predict damage in a finite element model of DAI is investigated.


2018 ◽  
Vol 89 (10) ◽  
pp. A42.1-A42
Author(s):  
Graham Neil SN ◽  
Jolly Amy E ◽  
Bourke Niall J ◽  
Scott Gregory ◽  
Cole James H ◽  
...  

BackgroundDementia rates are elevated after traumatic brain injury (TBI) and a subgroup develops chronic traumatic encephalopathy. Post-traumatic neurodegeneration can be measured by brain atrophy rates derived from neuroimaging, but it is unclear how atrophy relates to the initial pattern of injury.ObjectivesTo investigate the relationship between baseline TBI patterns and subsequent neurodegeneration measured by progressive brain atrophy.Methods55 patients after moderate-severe TBI (mean 3 years post-injury) and 20 controls underwent longitudinal MRI. Brain atrophy was quantified using the Jacobian determinant defined from volumetric T1 scans approximately one year apart. Diffuse axonal injury was measured using diffusion tensor imaging and focal injuries defined from T1 and FLAIR. Neuropsychological assessment was performed.ResultsAbnormal progressive brain atrophy was seen after TBI (~1.8%/year in white matter). This was accompanied by widespread reductions in fractional anisotropy, in keeping with the presence of diffuse axonal injury. There was a strong negative correlation between FA and brain atrophy, whereby areas of greater white matter damage showed greater atrophy over time.ConclusionsThe results show a strong relationship between the location of diffuse axonal injury and subsequent neurodegeneration. This suggests that TBI triggers progressive neurodegeneration through the long-lasting effects of diffuse axonal injury.


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.


2013 ◽  
Vol 17 (3 (67) p.1) ◽  
pp. 43-44
Author(s):  
O. I. Gerasimenko ◽  
Ye. G. Polivoda

The prevalence of diffuse axonal brain injury (DAI) among 936 people with a traumatic brain injury was investigated. Specific morphological features, permitting to diagnose DAI, and to determine the prescription of injuries have been determined by means of histological methods of research.


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