Experimental Determination of Pressure Wave Transmission to the Brain During Head-Neck Blast Tests

2013 ◽  
Author(s):  
Kyle Ott ◽  
Liming Voo ◽  
Andrew Merkle ◽  
Alexander Iwaskiw ◽  
Alexis Wickwire ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Head Injuries ◽  
Strong Association ◽  
Skull Fracture ◽  
Linear Acceleration ◽  
Military Operations ◽  
Blunt Impact ◽  
Injury Mechanisms ◽  
Inertial Loading

Traumatic Brain Injury (TBI) has been the termed the “signature injury” in wounded soldiers in recent military operations [1]. Evidence has shown a strong association between TBI and blast loading to the head due to exposure to explosive events [2, 3]. Head injury mechanisms in a primary blast environment remain elusive and are the subject of much speculation and hypotheses. However, brain injury mechanisms have traditionally been attributed to either a direct impact or a rapid head acceleration or deceleration. Extensive research has been performed regarding the effects of blunt trauma and inertial loading on head injuries [4, 5]. Direct impacts to the head can largely be described based on linear acceleration measurements that correlate to skull fracture and focal brain injuries [6]. Computational head modeling of blunt impact events has shown that the linear acceleration response correlates well with increases in brain pressure [7]. Intracranial pressure, therefore, has been one of the major quantities investigated for correlation to blast induced TBI injury mechanisms [8–14].

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 Management of Traumatic Brain Injury: A review Update

2017 ◽  
Vol 6 (2) ◽  
pp. 87-89
Author(s):  
ATM Ashadullah ◽  
Monirul Islam ◽  
Fazley Elahi Milad ◽  
Abdullah Alamgir ◽  
Md Shafiul Alam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Traumatic Injury ◽  
Loss Of Consciousness ◽  
Extradural Haematoma ◽  
Inner Surface ◽  
Injury Patient ◽  
Extradural Haematomas

Traumatic Brain Injury leads to serious consequences. Approximately half of all deaths is related to traumatic injury and the main cause of head trauma. Extradural haematomas (EDH) develops in all major head injuries. A head injury patient who is only temporary loss of consciousness and is left asleep may sometimes be found dead in the bed next morning due to extradural haematoma. Extradural haematoma which lies in between the inner surface of skull and stripes of dural membrane, are nearly always caused by, and located near a skull fracture. The collection takes several forms in terms of size, location, speed of development and effects they exert on patient. Immediate management is necessary to decrease the bad consequences. In this review the management of traumatic brain injury is highlighted.J Shaheed Suhrawardy Med Coll, 2014; 6(2):87-89

scholarly journals Structural brain injury in sports-related concussion

2012 ◽  
Vol 33 (6) ◽  
pp. E6 ◽  
Author(s):  
Scott L. Zuckerman ◽  
Andrew Kuhn ◽  
Michael C. Dewan ◽  
Peter J. Morone ◽  
Jonathan A. Forbes ◽  
...  
Keyword(s):  
Brain Injury ◽  
Literature Review ◽  
Brain Injuries ◽  
Case Reports ◽  
Head Injuries ◽  
Health Concern ◽  
Prevalence Data ◽  
Small Series ◽  
Structural Brain

Object Sports-related concussions (SRCs) represent a significant and growing public health concern. The vast majority of SRCs produce mild symptoms that resolve within 1–2 weeks and are not associated with imaging-documented changes. On occasion, however, structural brain injury occurs, and neurosurgical management and intervention is appropriate. Methods A literature review was performed to address the epidemiology of SRC with a targeted focus on structural brain injury in the last half decade. MEDLINE and PubMed databases were searched to identify all studies pertaining to structural head injury in sports-related head injuries. Results The literature review yielded a variety of case reports, several small series, and no prospective cohort studies. Conclusions The authors conclude that reliable incidence and prevalence data related to structural brain injuries in SRC cannot be offered at present. A prospective registry collecting incidence, management, and follow-up data after structural brain injuries in the setting of SRC would be of great benefit to the neurosurgical community.

scholarly journals Evaluation of Combat Helmet Behavior under Blunt Impact

2020 ◽  
Vol 10 (23) ◽  
pp. 8470
Author(s):  
Carlos Moure-Guardiola ◽  
Ignacio Rubio ◽  
Jacobo Antona-Makoshi ◽  
Álvaro Olmedo ◽  
José Antonio Loya ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Linear Acceleration ◽  
Human Head ◽  
Critical Parameters ◽  
Head Model ◽  
Ballistic Impacts ◽  
Impact Surface ◽  
Blunt Impact ◽  
Wide Range ◽  
Design And Manufacture

New threats are a challenge for the design and manufacture of modern combat helmets. These helmets must satisfy a wide range of impact velocities from ballistic impacts to blunt impacts. In this paper, we analyze European Regulation ECE R22.05 using a standard surrogate head and a human head model to evaluate combat helmet performance. Two critical parameters on traumatic brain analysis are studied for different impact locations, i.e., peak linear acceleration value and head injury criterion (HIC). The results obtained are compared with different injury criteria to determine the severity level of damage induced. Furthermore, based on different impact scenarios, analyses of the influence of impact velocity and the geometry impact surface are performed. The results show that the risks associated with a blunt impact can lead to a mild traumatic brain injury at high impact velocities and some impact locations, despite satisfying the different criteria established by the ECE R22.05 standard. The results reveal that the use of a human head for the estimation of brain injuries differs slightly from the results obtained using a surrogate head. Therefore, the current combat helmet configuration must be improved for blunt impacts. Further standards should take this into account and, consequently, combat helmet manufacturers on their design process.

scholarly journals Validation of the scandinavian guidelines for initial management of minor and moderate head trauma in children

2020 ◽  
Author(s):  
Caroline Sönnerqvist ◽  
Ole Brus ◽  
Magnus Olivecrona
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Negative Predictive Value ◽  
Head Trauma ◽  
Predictive Value ◽  
Brain Injuries ◽  
Head Injuries ◽  
Traumatic Brain Injuries ◽  
Predictive Values ◽  
Initial Management

Abstract Background Head trauma in children is common, with a low rate of clinically important traumatic brain injury. CT scan is the reference standard for diagnosis of traumatic brain injury, of which the increasing use is alarming because of the risk of induction of lethal malignancies. Recently, the Scandinavian Neurotrauma Committee derived new guidelines for the initial management of minor and moderate head trauma. Our aim was to validate these guidelines. Methods We applied the guidelines to a population consisting of children with mild and moderate head trauma, enrolled in the study: “Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study” by Kuppermann et al. (Lancet 374(9696):1160–1170, https://doi.org/10.1016/S0140-6736(09)61558-0, 2009). We calculated the negative predictive values of the guidelines to assess their ability to distinguish children without clinically-important traumatic brain injuries and traumatic brain injuries on CT scans, for whom CT could be omitted. Results We analysed a population of 43,025 children. For clinically-important brain injuries among children with minimal head injuries, the negative predictive value was 99.8% and the rate was 0.15%. For traumatic findings on CT, the negative predictive value was 96.9%. Traumatic finding on CT was detected in 3.1% of children with minimal head injuries who underwent a CT examination, which accounts for 0.45% of all children in this group. Conclusion Children with minimal head injuries can be safely discharged with oral and written instructions. Use of the SNC-G will potentially reduce the use of CT.

Intracranial pressure–based validation and analysis of traumatic brain injury using a new three-dimensional finite element human head model

2019 ◽  
Vol 234 (1) ◽  
pp. 3-15 ◽  
Author(s):  
Tanu Khanuja ◽  
Harikrishnan Narayanan Unni
Keyword(s):  
Finite Element ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Brain Injuries ◽  
Three Dimensional ◽  
Human Head ◽  
Von Mises Stress ◽  
Head Model ◽  
Injury Mechanisms ◽  
Von Mises

Traumatic brain injuries are life-threatening injuries that can lead to long-term incapacitation and death. Over the years, numerous finite element human head models have been developed to understand the injury mechanisms of traumatic brain injuries. Many of these models are erroneous and used ellipsoidal or spherical geometries to represent brain. This work is focused on the development of high-quality, comprehensive three-dimensional finite element human head model with accurate representation of cerebral sulci and gyri structures in order to study traumatic brain injury mechanisms. Present geometry, predicated on magnetic resonance imaging data consist of three rudimentary components, that is, skull, cerebrospinal fluid with the ventricular system, and the soft tissues comprising the cerebrum, cerebellum, and brain stem. The brain is modeled as a hyperviscoelastic material. Meshed model with 10 nodes modified tetrahedral type element (C3D10M) is validated against two cadaver-based impact experiments by comparing the intracranial pressures at different locations of the head. Our results indicate a better agreement with cadaver results, specifically for the case of frontal and parietal intracranial pressure values. Existing literature focuses mostly on intracranial pressure validation, while the effects of von Mises stress on brain injury are not analyzed in detail. In this work, a detailed interpretation of neurological damage resulting from impact injury is performed by analyzing von Mises stress and intracranial pressure distribution across numerous segments of the brain. A reasonably good correlation with experimental data signifies the robustness of the model for predicting injury mechanisms based on clinical predictions of injury tolerance criteria.

scholarly journals Ballistic Helmets: Their Design, Materials, and Performance Against Traumatic Brain Injury

2012 ◽  
Author(s):  
S. G. Kulkarni ◽  
X.-L. Gao ◽  
N. V. David ◽  
S. E. Horner ◽  
J. Q. Zheng
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injuries ◽  
Constitutive Models ◽  
Night Vision ◽  
Future Research ◽  
Military Operations ◽  
Ballistic Performance ◽  
Design Materials ◽  
And Performance

Protecting a soldier’s head from injury is critical to function and survivability. Traditionally, combat helmets have been utilized to provide protection against shrapnel and ballistic threats, which have reduced head injuries and fatalities. However, home-made bombs or improvised explosive devices (IEDs) have been increasingly used in theatre of operations since the Iraq and Afghanistan conflicts. Traumatic brain injury (TBI), particularly blast-induced TBI, which is typically not accompanied by external body injuries, is becoming increasingly prevalent among injured soldiers. The response of personal protective equipment, especially combat helmets, to blast events is relatively unknown. There is an urgent need to develop head protection systems with blast protection/ mitigation capabilities in addition to ballistic protection. Modern military operations, ammunitions, and technology driven war tactics require a lightweight headgear that integrates protection mechanisms (against ballistics, blasts, heat, and noise), sensors, night vision devices, and laser range finders into a single system. The current paper provides a comparative study on the design, materials, ballistic and blast performance of the combat helmets used by the U.S. Army based on a comprehensive and critical review of existing studies. Mechanisms of ballistic energy absorption, effects of helmet curvatures on ballistic performance, and performance measures of helmets are discussed. Properties of current helmet materials (including Kevlar® K29 and K129 fibers, and thermoset resins) and future candidate materials for helmets (such as nano-composites, thermoplastic polymers, and carbon fibers) are elaborated. Also, experimental and computational studies on blast-induced TBI are examined, and constitutive models developed for brain tissues are reviewed. Finally, the effectiveness of current combat helmets against TBI is analyzed along with possible avenues for future research.

scholarly journals Neurotoxic tau oligomers after single versus repetitive mild traumatic brain injury

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Alice Bittar ◽  
Nemil Bhatt ◽  
Tasneem F Hasan ◽  
Mauro Montalbano ◽  
Nicha Puangmalai ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Head Injuries ◽  
Long Term Potentiation ◽  
Traumatic Brain Injuries ◽  
Tau Oligomers ◽  
Mild Traumatic Brain Injuries ◽  
Single Versus

Abstract Mild traumatic brain injury accounts for the majority of head injuries and has been correlated with neurodegeneration and dementia. While repetitive mild traumatic brain injury is highly correlated to neurodegeneration, the correlation of a single mild traumatic brain injury with neurodegeneration is still unclear. Because tau aggregates are the main form of mild traumatic brain injury induced pathology, toxic forms of tau protein most likely play a role in the development of post-mild traumatic brain injury neurodegeneration. Therefore, it becomes crucial to characterize the properties of soluble tau aggregates in single versus repetitive mild traumatic brain injury. Herein, we isolated tau oligomers from wild-type mice exposed to single or repetitive mild traumatic brain injury and characterized the tau aggregates at functional, biochemical and biophysical levels. We demonstrated that single versus repetitive mild traumatic brain injuries frequencies lead to the formation of different tau oligomeric polymorphisms. These polymorphisms express different long-term potentiation impairment potencies, toxicity potentials, morphologies and strain indicating properties. To our knowledge, this is the first evidence that soluble tau oligomers derived from single versus repetitive mild traumatic brain injuries form distinct polymorphisms that possibly correlate with the risk of neurodegeneration after mild traumatic brain injury.

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 Epidemiology of Pediatric Traumatic Brain Injury at Sylvanus Olympio University Hospital of Lomé in Togo

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Pilakimwe Egbohou ◽  
Tabana Mouzou ◽  
Pikabalo Tchetike ◽  
Hamza Doles Sama ◽  
Sarakawabalo Assenouwe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Brain Injuries ◽  
Injury Severity ◽  
Road Traffic ◽  
Skull Fracture ◽  
University Hospital ◽  
Pediatric Traumatic Brain Injury ◽  
The Mean

Introduction. Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods. This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients’ records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results. We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p<0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion. pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.

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