Effect of aging on brain injury prediction in rotational head trauma--a parameter study with a rat finite element model.

OBJECTIVE: The aim of this study was to investigate the possible effects of age-related intracranial changes on the potential outcome of diffuse axonal injuries and acute subdural hematoma under rotational head loading. METHODS: A simulation-based parametric study was conducted using an updated and validated finite element model of a rat head. The validation included a comparison of predicted brain cortex sliding with respect to the skull. Further, model material properties were modified to account for aging; predicted tissue strains were compared with experimental data in which groups of rats in 2 different lifecycle stages, young adult and mature adult, were subjected to rotational trauma. For the parameter study, 2 age-dependent factors-brain volume and region-specific brain material properties-were implemented into the model. The models young adult and old age were subjected to several injurious and subinjurious sagittal plane rotational acceleration levels. RESULTS: Sequential analysis of the simulated trauma progression indicates that an increase in acute subdural hematoma injury risk indicator occurs at an early stage of the trauma, whereas an increase in diffuse axonal injury risk indicators occurs at a later stage. Tissue stiffening from young adult to mature adult rats produced an increase in strain-based thresholds accompanied by a wider spread of strain distribution toward the rear part of the brain, consistent with rotational trauma experiments with young adult and mature adult rats. Young adult to old age brain tissue softening and brain atrophy resulted in an increase in diffuse axonal injuries and acute subdural hematoma injury risk indicators, respectively. CONCLUSIONS: The findings presented in this study suggest that age-specific injury thresholds should be developed to enable the development of superior restraint systems for the elderly. The findings also motivate other further studies on age-dependency of head trauma.

Kinematics of the unrestrained vehicle occupants in side-impact crashes.

A test series involving direct right-side impact of a moving wall on unsupported, unrestrained cadavers with no arms was undertaken to better understand human kinematics and injury mechanisms during side impact at realistic speeds. The tests conducted provided a unique opportunity for a detailed analysis of the kinematics resulting from side impact. Specifically, this study evaluated the 3-dimensional (3D) kinematics of 3 unrestrained male cadavers subjected to lateral impact by a multi-element load wall carried by a pneumatically propelled rail-mounted sled reproducing a conceptual side crash impact. Three translations and 3 rotations characterize the movement of a solid body in the space, the 6 degrees of freedom (6DoF) kinematics of 15 bone segments were obtained from the 3D marker motions and computed tomography (CT)-defined relationships between the maker array mounts and the bones. The moving wall initially made contact with the lateral aspect of the pelvis, which initiated lateral motion of the spinal segments beginning with the pelvis and moving sequentially up through the lumbar spine to the thorax. Analyzing the 6DoF motions kinematics of the ribs and sternum followed right shoulder contact with the wall. Overall thoracic motion was assessed by combining the thoracic bone segments as a single rigid body. The kinematic data presented in this research provides quantified subject responses and boundary condition interactions that are currently unavailable for lateral impact.

Whole-body response to pure lateral impact.

The objective of the current study was to provide a comprehensive characterization of human biomechanical response to whole-body, lateral impact. Three approximately 50th-percentile adult male PMHS were subjected to right-side pure lateral impacts at 4.3 ± 0.1 m/s using a rigid wall mounted to a rail-mounted sled. Each subject was positioned on a rigid seat and held stationary by a system of tethers until immediately prior to being impacted by the moving wall with 100 mm pelvic offset. Displacement data were obtained using an optoelectronic stereophotogrammetric system that was used to track the 3D motions of the impacting wall sled; seat sled, and reflective targets secured to the head, spine, extremities, ribcage, and shoulder complex of each subject. Kinematic data were also recorded using 3-axis accelerometer cubes secured to the head, pelvis, and spine at the levels of T1, T6, T11, and L3. Chest deformation in the transverse plane was recorded using a single chestband. Following the impact the subject was captured in an energy-absorbing net that provided a controlled non-injurious deceleration. The wall maintained nearly constant velocity throughout the impact event. One of the tested subjects sustained 16 rib fractures as well as injury to the struck shoulder while the other two tested subjects sustained no injuries. The collected response data suggest that the shoulder injury may have contributed to the rib fractures in the injured subject. The results suggest that the shoulder presents a substantial load path and may play an important role in transmitting lateral forces to the spine, shielding and protecting the ribcage. This characterization of whole-body, lateral impact response provides quantified subject responses and boundary condition interactions that are currently unavailable for whole-body, lateral impacts at impact speeds less than 6.7 m/s.

Correlates to traumatic brain injury in nonhuman primates.

BACKGROUND: Traumatic brain injury (TBI) is a major health problem, both in terms of the economic cost to society and the survivor's quality of life. The development of devices to protect against TBI requires criteria that relate observed injury to measurements of head kinematics. The objective of this study is to find the best statistical correlates to impact-induced TBI in nonhuman primates using a qualified, self-consistent set of historical kinematic and TBI data from impact tests on nonhuman primates. METHODS: A database was constructed and qualified from historical head impact tests on nonhuman primates. Multivariate logistic regression analysis with backwards stepwise elimination was performed. Variables considered are the peak rotational acceleration (Omegamax), the peak linear acceleration (Amax), and the number of impacts (N). RESULTS: Bivariate combinations of angular acceleration and the number of impacts are the best correlates to all modes of TBI considered, i.e., concussion, subarachnoid hemorrhage, brain contusion, and subdural hematoma. For a nonhuman primate with 100-g brain mass, the criteria that the probability of TBI is less than 10% by injury mode are:Concussion: OmegamaxN(0.84) < 70 krad/s/s SAH: OmegamaxN(0.70) < 160 krad/s/s Contusion: Omegamax N(0.35) < 160 krad/s/s SDH: Omegamax N(0.60) < 280 krad/s/s CONCLUSIONS: Based on this dataset, the best statistically based risk factor for all modes of TBI in nonhuman primates is the bivariate combination of rotational acceleration and number of impacts.

Neck injury mechanisms during direct face impact.

STUDY DESIGN: Digitized measurements of the intervertebral motions using cervical cineradiographs of 10 volunteers during direct impacts applied to their faces. OBJECTIVES: To clarify the cervical spine motion during direct face impact and postulate some mechanisms of neck injuries. SUMMARY OF BACKGROUND DATA: Neck injury occurs mostly in traffic or falling accidents. Hyperextension of the neck is considered the most common mechanism of the injury because most victims have lacerations or contusions on their faces. METHODS: A low-level backward impact load was applied to 10 healthy male volunteers' faces at the forehead and maxilla via a strap using a free-falling small mass. Cervical vertebral motion was recorded by radiograph cineradiography during the impact. RESULTS: The upper cervical spine showed a flexion motion for both conditions. Consequently, the cervical spine had an S-shaped curvature similar to that in cervical retraction. Intervertebral motions of the cervical spine were evaluated using an radiograph frame taken at the maximum cervical retraction. For the forehead load, intervertebral motion at C1-C2 was flexion, and motions of the lower cervical spine were extension. For the maxilla load, intervertebral motions from occiput-C1 through C4-C5 were flexion. The inflection point of the curvature was influenced by the impact location. CONCLUSION: We detected a flexion motion of the upper or middle cervical spine during direct face impact. In an actual accident, if the cervical spine is forced into similar motion, we speculate that neck injury would occur in this retraction-like curvature of the cervical spine.

Cervical vertebral motions and biomechanical responses to direct loading of human head.

There is little known data characterizing the biomechanical responses of the human head and neck under direct head loading conditions. However, the evaluation of the appropriateness of current crash test dummy head-neck systems is easily accomplished. Such an effort, using experimental means, generates and provides characterizations of human head-neck response to several direct head loading conditions. Low-level impact loads were applied to the head and face of volunteers and dummies. The resultant forces and moments at the occipital condyle were calculated. For the volunteers, activation of the neck musculature was determined using electromyography (EMG). In addition, cervical vertebral motions of the volunteers have been taken by means of X-ray cineradiography. The Ethics Committee of Tsukuba University approved the protocol of the experiments in advance. External force of about 210 N was applied to the head and face of five volunteers with an average age of 25 for the duration of 100 msec or so, via a strap at one of four locations in various directions: (1) an upward load applied to the chin, (2) a rearward load applied to the chin without facial mask, (3) a rearward load applied to the chin with the facial mask, and (4) a rearward load applied to the forehead. The same impact force as those for the human volunteers was also applied to HY-III, THOR, and BioRID. We found that cervical vertebral motions differ markedly according to the difference in impact loading condition. Some particular characteristics are also found, such as the flexion or extension of the upper cervical vertebrae (C0, C1, and C2) or middle cervical vertebrae (C3-C4), showing that the modes of cervical vertebral motions are markedly different among the different loading conditions. We also found that the biofidelity of dummies to neck response characteristics of the volunteers at the low-level impact loads is in the order of BioRID, THOR, and HY-III. It is relevant in this regard that the BioRID dummy was designed for a low-severity impact environment, whereas THOR and HY-III were optimized for higher-severity impacts.