The Mechanics of Traumatic Brain Injury: A Review of What We Know and What We Need to Know for Reducing Its Societal Burden

Meaney, David F.; Morrison, Barclay; Bass, Cameron Dale

doi:10.1115/1.4026364

Cited by 203 publications

(136 citation statements)

References 196 publications

(236 reference statements)

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“…1 To better understand the mechanisms of brain injury at the macroscale level, numerous kinematic injury metrics have been proposed (e.g., peak linear [ 6 and the HIT severity index 7 ). Unfortunately, they are not directly related to the brain mechanical responses believed to initiate the injury, 8 and as of yet, no consensus has been reached on an appropriate injury metric or a threshold to date. Further, these metrics have been shown to be less effective in injury prediction than brain mechanical responses estimated from validated finite element (FE) models.…”

Section: Introductionmentioning

confidence: 99%

White Matter Injury Susceptibility via Fiber Strain Evaluation Using Whole-Brain Tractography

Zhao

Ford

Flashman

et al. 2016

Journal of Neurotrauma

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Microscale brain injury studies suggest axonal elongation as a potential mechanism for diffuse axonal injury (DAI). Recent studies have begun to incorporate white matter (WM) structural anisotropy in injury analysis, with initial evidence suggesting improved injury prediction performance. In this study, we further develop a tractography-based approach to analyze fiber strains along the entire lengths of fibers from voxel-or anatomically constrained whole-brain tractography. This technique potentially extends previous element-or voxel-based methods that instead utilize WM fiber orientations averaged from typically coarse elements or voxels. Perhaps more importantly, incorporating tractography-based axonal structural information enables assessment of the overall injury risks to functionally important neural pathways and the anatomical regions they connect, which is not possible with previous methods. A DAI susceptibility index was also established to quantify voxel-wise WM local structural integrity and tract-wise damage of individual neural pathways. This ''graded'' injury susceptibility potentially extends the commonly employed treatment of injury as a simple binary condition. As an illustration, we evaluate the DAI susceptibilities of WM voxels and transcallosal fiber tracts in three idealized head impacts. Findings suggest the potential importance of the tractography-based approach for injury prediction. These efforts may enable future studies to correlate WM mechanical responses with neuroimaging, cognitive alteration, and concussion, and to reveal the relative vulnerabilities of neural pathways and identify the most vulnerable ones in real-world head impacts.

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Section: Introductionmentioning

confidence: 99%

White Matter Injury Susceptibility via Fiber Strain Evaluation Using Whole-Brain Tractography

Zhao

Ford

Flashman

et al. 2016

Journal of Neurotrauma

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“…Biomechanical responses, such as pressure, stress, and strain, are correlated to brain tissue damage [21,22], and they provide valuable information on the response of brain tissue to external mechanical loading, such as BOP. Our objective was to perform computational investigations on the interaction of a blast wave with an animal head and, from the biomechanical responses of the brain, determine the contribution of head acceleration to bTBI.…”

Section: Introductionmentioning

confidence: 99%

Untangling the Effect of Head Acceleration on Brain Responses to Blast Waves

Mao

Unnikrishnan

Rakesh

et al. 2015

Journal of Biomechanical Engineering

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Multiple injury-causing mechanisms, such as wave propagation, skull flexure, cavitation, and head acceleration, have been proposed to explain blast-induced traumatic brain injury (bTBI). An accurate, quantitative description of the individual contribution of each of these mechanisms may be necessary to develop preventive strategies against bTBI. However, to date, despite numerous experimental and computational studies of bTBI, this question remains elusive. In this study, using a two-dimensional (2D) rat head model, we quantified the contribution of head acceleration to the biomechanical response of brain tissues when exposed to blast waves in a shock tube. We compared brain pressure at the coup, middle, and contre-coup regions between a 2D rat head model capable of simulating all mechanisms (i.e., the all-effects model) and an acceleration-only model. From our simulations, we determined that head acceleration contributed 36-45% of the maximum brain pressure at the coup region, had a negligible effect on the pressure at the middle region, and was responsible for the low pressure at the contre-coup region. Our findings also demonstrate that the current practice of measuring rat brain pressures close to the center of the brain would record only two-thirds of the maximum pressure observed at the coup region. Therefore, to accurately capture the effects of acceleration in experiments, we recommend placing a pressure sensor near the coup region, especially when investigating the acceleration mechanism using different experimental setups.

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“…These difficulties provide a challenging environment for research. However the last 50 years have produced a truly impressive advancement in such technology (Meany et al 2014). …”

Section: Human Head Modelingmentioning

confidence: 99%

Finite element modeling of human brain response to football helmet impacts

Darling

Muthuswamy

Rajan

2016

Computer Methods in Biomechanics and Biomedical Engineering

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The football helmet is a device used to help mitigate the occurrence of impactrelated traumatic (TBI) and minor traumatic brain injuries (mTBI) in the game of American football. The current design methodology of using a hard shell with an energy absorbing liner may be adequate for minimizing TBI, however it has had less effect in minimizing mTBI. The latest research in brain injury mechanisms has established that the current design methodology has produced a helmet to reduce linear acceleration of the head. However, angular accelerations also have an adverse effect on the brain response, and must be investigated as a contributor of brain injury.To help better understand how the football helmet design features effect the brain response during impact, this research develops a validated football helmet model and couples it with a full LS-DYNA human body model developed by the Global Human Body Modeling Consortium (v4.1.1). The human body model is a conglomeration of several validated models of different sections of the body. Of particular interest for this research is the Wayne State University Head Injury Model for modeling the brain. These human body models were validated using a combination of cadaveric and animal studies.In this study, the football helmet was validated by laboratory testing using drop tests on the crown of the helmet. By coupling the two models into one finite element model, the brain response to impact loads caused by helmet design features can be investigated. In the present research, LS-DYNA is used to study a helmet crown impact with a rigid steel plate so as to obtain the strain-rate, strain, and stress experienced in the corpus callosum, midbrain, and brain stem as these anatomical regions are areas of concern with respect to mTBI.ii ACKNOWLEDGMENTS

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The Mechanics of Traumatic Brain Injury: A Review of What We Know and What We Need to Know for Reducing Its Societal Burden

Cited by 203 publications

References 196 publications

White Matter Injury Susceptibility via Fiber Strain Evaluation Using Whole-Brain Tractography

White Matter Injury Susceptibility via Fiber Strain Evaluation Using Whole-Brain Tractography

Untangling the Effect of Head Acceleration on Brain Responses to Blast Waves

Finite element modeling of human brain response to football helmet impacts

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