Predictions of neonatal porcine bridging vein rupture and extra-axial hemorrhage during rapid head rotations

Pasquesi, Stephanie A.; Seidi, Morteza; Hajiaghamemar, Marzieh; Margulies, Susan S.

doi:10.1016/j.jmbbm.2020.103740

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…With the instantaneous center of rotation close to the center of the head, the measured accelerations lead to angular velocities and angular accelerations (see Supplementary Table S1) that are above the thresholds for 50% chance of extra-axial hemorrhage established by Pasquesi and associates in piglets. 15 Human infant bridging veins seem to endure similar or slightly higher stretch and stress before rupturing, depending on the type of loading. 15 This suggests that the measured accelerations could be in a harmful range if the transfer from skull kinematics to bridging vein loading is the same in infants as in piglets.…”

Section: Discussionmentioning

confidence: 99%

“…15 Human infant bridging veins seem to endure similar or slightly higher stretch and stress before rupturing, depending on the type of loading. 15 This suggests that the measured accelerations could be in a harmful range if the transfer from skull kinematics to bridging vein loading is the same in infants as in piglets. However, the latter has yet to be investigated.…”

Section: Discussionmentioning

confidence: 99%

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Violent Infant Surrogate Shaking: Continuous High-Magnitude Centripetal Force and Abrupt Shift in Tangential Acceleration May Explain High Risk of Subdural Hemorrhage

Stray-Pedersen

Strisland

Rognum

et al. 2021

Neurotrauma Reports

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Violent shaking is believed to be a common mechanism of injury in pediatric abusive head trauma. Typical intracranial injuries include subdural and retinal hemorrhages. Using a laboratory surrogate model we conducted experiments evaluating the head motion patterns that may occur in violent shaking. An anthropomorphic test device (ATD; Q0 dummy) matching an infant of 3.5 kg was assembled. The head interior was equipped with accelerometers enabling assessment of three-axial accelerations. Fifteen volunteers were asked to shake the surrogate vigorously holding a firm grip around the torso. We observed the volunteers performing manual shaking of the surrogate at a median duration of 15.5 sec (range 5-54 sec). Typical acceleration/deceleration patterns were produced after 2-3 shakes with a steady-state shaking motion at a pace of 4-6 cycles (back and forth) per second. Mean peak sagittal tangential accelerations at the vertex were 45.7g (range 14.2-105.1g). The acceleration component in the orthogonal direction, the radial acceleration, fluctuated around a negative mean of more than 4g showing that the surrogate head was continuously subjected to centripetal forces caused by rotations. This surrogate experiment showed that violent shaking may induce high peak tangential accelerations and concomitantly a continuous high-magnitude centripetal force. We hypothesize that the latter component may cause increased pressure in the subdural compartment in the cranial roof and may cause constant compression of the brain and possibly increased stretching or shearing of the bridging veins. This may contribute to the mechanism accountable for subdural hematoma in abusive head trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Violent Infant Surrogate Shaking: Continuous High-Magnitude Centripetal Force and Abrupt Shift in Tangential Acceleration May Explain High Risk of Subdural Hemorrhage

Stray-Pedersen

Strisland

Rognum

et al. 2021

Neurotrauma Reports

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“…Nevertheless, Costa et al [20] modelled the geometry as an inflated vessel instead of collapsed, which means the cross-sectional area was correct but not its shape. Additionally, BVs were modelled as elastoplastic, although their non-linear elastic behaviour has been reported [10,[25][26][27][28][29]. Nevertheless, in the data reported by Monea et al [24], by analysing the stress-strain curves, it is evident that damage is present for a significant strain portion.…”

Section: Introductionmentioning

confidence: 99%

The Significance of Cross-Sectional Shape Accuracy and Non-Linear Elasticity on the Numerical Modelling of Cerebral Veins under Tensile Loading

Fernandes,

Silveira

2023

Biology

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Traumatic brain injury (TBI) is a serious global health issue, leading to serious disabilities. One type of TBI is acute subdural haematoma (ASDH), which occurs when a bridging vein ruptures. Many numerical models of these structures, mainly based on the finite element method, have been developed. However, most rely on linear elasticity (without validation) and others on simplifications at the geometrical level. An example of the latter is the assumption of a regular cylinder with a constant radius, or the geometry of the vein acquired from medical images. Unfortunately, these do not replicate the real conditions of a mechanical tensile test. In this work, the main goal is to evaluate the influence of the vein’s geometry in its mechanical behaviour under tensile loading, simulating the real conditions of experimental tests. The second goal is to implement a hyperelastic model of the bridging veins where it would be possible to observe its non-linear elastic behaviour. The results of the developed finite element models were compared to experimental data available in the literature and other models. It was possible to conclude that the geometry of the vein structure influences the tensile stress–strain curve, which means that flattened specimens should be modelled when validating constitutive models for bridging veins. Additionally, the implementation of hyperelastic material models has been verified, highlighting the potential application of the Marlow and reduced polynomial (of fourth and sixth orders) constitutive models.

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“…For example, a recent study has shown that the distribution of the FE predicted axonal deformations correlate with the locations of acute traumatic axonal injury in a pig model 22 . Another study showed that FE modelling can predict rupture of bridging veins in the pig model 23 . In our recent paper, we showed that computational modelling of TBI in rats predicts patterns of post-traumatic cortical lesions and glial and axonal injuries 24 .…”

Section: Introductionmentioning

confidence: 99%

Multiscale modelling of cerebrovascular injury reveals the role of vascular anatomy and parenchymal shear stresses

Khosroshahi

Donat

McGarry

et al. 2021

Sci Rep

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Neurovascular injury is often observed in traumatic brain injury (TBI). However, the relationship between mechanical forces and vascular injury is still unclear. A key question is whether the complex anatomy of vasculature plays a role in increasing forces in cerebral vessels and producing damage. We developed a high-fidelity multiscale finite element model of the rat brain featuring a detailed definition of the angioarchitecture. Controlled cortical impacts were performed experimentally and in-silico. The model was able to predict the pattern of blood–brain barrier damage. We found strong correlation between the area of fibrinogen extravasation and the brain area where axial strain in vessels exceeds 0.14. Our results showed that adjacent vessels can sustain profoundly different axial stresses depending on their alignment with the principal direction of stress in parenchyma, with a better alignment leading to larger stresses in vessels. We also found a strong correlation between axial stress in vessels and the shearing component of the stress wave in parenchyma. Our multiscale computational approach explains the unrecognised role of the vascular anatomy and shear stresses in producing distinct distribution of large forces in vasculature. This new understanding can contribute to improving TBI diagnosis and prevention.

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Predictions of neonatal porcine bridging vein rupture and extra-axial hemorrhage during rapid head rotations

Cited by 7 publications

References 27 publications

Violent Infant Surrogate Shaking: Continuous High-Magnitude Centripetal Force and Abrupt Shift in Tangential Acceleration May Explain High Risk of Subdural Hemorrhage

Violent Infant Surrogate Shaking: Continuous High-Magnitude Centripetal Force and Abrupt Shift in Tangential Acceleration May Explain High Risk of Subdural Hemorrhage

The Significance of Cross-Sectional Shape Accuracy and Non-Linear Elasticity on the Numerical Modelling of Cerebral Veins under Tensile Loading

Multiscale modelling of cerebrovascular injury reveals the role of vascular anatomy and parenchymal shear stresses

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