Rotational Acceleration Duration Affects Brain Strains in Lateral Impact

2007 ◽  
Author(s):  
Jianrong Li ◽  
Jiangyue Zhang ◽  
Narayan Yoganandan ◽  
Frank A. Pintar ◽  
Thomas A. Gennarelli
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Angular Acceleration ◽  
The United States ◽  
Physical Models ◽  
Lateral Impact ◽  
Diffuse Brain Injury ◽  
Diffuse Brain

Traumatic brain injury is a leading cause of disability and fatality in the United States. Approximately two million traumatic brain injury cases occur every year [1]. Motor vehicle crashes are a primary source [2]. Both clinical and laboratory studies have been conducted to understand injury mechanisms and establish injury thresholds [3, 4]. Physical models have also been used to investigate injury biomechanics [5, 6]. Angular acceleration is considered as a major cause of diffuse brain injuries (DBI) [7, 8], while the angular velocity is chosen as a suitable load descriptor for a diffuse brain injury criterion [4]. The present study is focused on the effect of angular acceleration duration on brain strains due to lateral impact.

scholarly journals Classification of traumatic brain injury severity using retrospective data

2017 ◽  
Vol 7 (11) ◽  
pp. 23
Author(s):  
Sandra Rogers ◽  
Amber W. Trickey
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
The United States ◽  
Retrospective Data ◽  
Trauma Centers ◽  
Classification Methods ◽  
Severity Classification ◽  
Brain Injured

Objective: Accurate classification of traumatic brain injury (TBI) severity is essential to brain injury research. TBI heterogeneity complicates classification of the injury; is a significant barrier in the design of therapeutic interventions; and results in retrospective data which is difficult to translate. The objective of this study is to describe the differences in two current tools used in the classification of TBI severity, the Glasgow Coma Scale (GCS) and the head Abbreviated Injury Score (AIS), using retrospective data to compare their performance.Methods: Using correlational and descriptive statistics, this study examined two TBI severity classification methods across a large sample of TBI patients (N = 56,131), who were treated at level I and level II trauma centers in the United States and were included in the 2010 National Sample Program (NSP) of the National Trauma Data Bank (NTDB®).Results: The study population was 67% male, 67% non-Hispanic white, treated most often in trauma centers in the South (38%), with blunt trauma (93%) and from non-motor vehicle collisions (MVC’s) (56%). Observation of the AIS classification system demonstrated that it tends to over-score TBI severity compared to the GCS classification. The methods (GCS & AIS) had a weak, inverse relationship with a correlation coefficient (Pearson’s r) of -0.3980, which was significant at p < .001.Conclusions: The current study addressed the difficulties associated with categorizing TBI severity when analyzing retrospective data.  Although AIS is commonly used to classify severity in retrospective data when GCS is unavailable, the relationship between the two scales is relatively unknown. Results show that AIS and GCS are more closely related for severely brain injured patients but in cases of mild and moderate injury, AIS is less predictive of GCS. Since they are often used in conjunction in identifying brain injured severity in retrospective data, researchers cannot be certain that the tools are similarly classifying mild, moderate, and severe injuries. This study reinforces the need for additional TBI severity classification methods, such as neuroimaging techniques and biomarkers.

scholarly journals The Association of Early Electrocardiographic Abnormalities With Brain Injury Severity and Outcome in Severe Traumatic Brain Injury

2021 ◽  
Vol 11 ◽  
Author(s):  
Jelmer-Joost Lenstra ◽  
Lidija Kuznecova-Keppel Hesselink ◽  
Sacha la Bastide-van Gemert ◽  
Bram Jacobs ◽  
Maarten Willem Nicolaas Nijsten ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Cardiac Arrhythmias ◽  
Injury Severity ◽  
Thoracic Injury ◽  
Diffuse Brain Injury ◽  
Severe Tbi ◽  
Ecg Abnormalities ◽  
Diffuse Brain

The aim of this study was to evaluate the frequency of electrocardiographic (ECG) abnormalities in the acute phase of severe traumatic brain injury (TBI) and the association with brain injury severity and outcome. In contrast to neurovascular diseases, sparse information is available on this issue. Data of adult patients with severe TBI admitted to the Intensive Care Unit (ICU) for intracranial pressure monitoring of a level-1 trauma center from 2002 till 2018 were analyzed. Patients with a cardiac history were excluded. An ECG recording was obtained within 24 h after ICU admission. Admission brain computerized tomography (CT)-scans were categorized by Marshall-criteria (diffuse vs. mass lesions) and for location of traumatic lesions. CT-characteristics and maximum Therapy Intensity Level (TILmax) were used as indicators for brain injury severity. We analyzed data of 198 patients, mean (SD) age of 40 ± 19 years, median GCS score 3 [interquartile range (IQR) 3–6], and 105 patients (53%) had thoracic injury. In-hospital mortality was 30%, with sudden death by cardiac arrest in four patients. The incidence of ECG abnormalities was 88% comprising ventricular repolarization disorders (57%) mostly with ST-segment abnormalities, conduction disorders (45%) mostly with QTc-prolongation, and arrhythmias (38%) mostly of supraventricular origin. More cardiac arrhythmias were observed with increased grading of diffuse brain injury (p = 0.042) or in patients treated with hyperosmolar therapy (TILmax) (65%, p = 0.022). No association was found between ECG abnormalities and location of brain lesions nor with thoracic injury. Multivariate analysis with baseline outcome predictors showed that cardiac arrhythmias were not independently associated with in-hospital mortality (p = 0.097). Only hypotension (p = 0.029) and diffuse brain injury (p = 0.017) were associated with in-hospital mortality. In conclusion, a high incidence of ECG abnormalities was observed in patients with severe TBI in the acute phase after injury. No association between ECG abnormalities and location of brain lesions or presence of thoracic injury was present. Cardiac arrhythmias were indicative for brain injury severity but not independently associated with in-hospital mortality. Therefore, our findings likely suggest that ECG abnormalities should be considered as cardiac mimicry representing the secondary effect of traumatic brain injury allowing for a more rationale use of neuroprotective measures.

Treating Severe Traumatic Brain Injury: Combining Neurofeedback and Hyperbaric Oxygen Therapy in a Single Case Study

2021 ◽  
pp. 155005942110682
Author(s):  
Rebecca D White ◽  
Robert P Turner ◽  
Noah Arnold ◽  
Annie Bernica ◽  
Brigitte N Lewis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Short Term Memory ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Single Case ◽  
Treatment Center

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days. After gaining consciousness, he was discharged to a brain injury treatment center that worked with physical, speech, and occupational issues. He was discharged after eight months with significant speech, ambulation, spasticity, and cognitive issues as well as the onset of posttraumatic epilepsy. His parents sought hyperbaric oxygen treatment (HBOT) from a doctor in Louisiana. After 165 dives, the HBOT doctor recommended an addition of neurofeedback (NFB) therapy. In March 2019 the patient started NFB therapy intermixed with HBOT. The combination of NFB and HBOT improved plasticity and functionality in the areas of injury and the correlated symptoms including short-term memory, personality, language, and executive function, as well as significantly reducing the incidence of seizures. Severe brain injuries often leave lasting deficits with little hope for major recovery and there is a need for further research into long-term, effective neurological treatments for severe brain injuries. These results suggest that HBOT combined with NFB may be a viable option in treating severe brain injuries and should be investigated.

Information for Rehabilitation Counselors on Guardianship and Alternatives to Guardianship for Persons with Traumatic Brain Injuries

2004 ◽  
Vol 35 (1) ◽  
pp. 3-9
Author(s):  
Michelle McGraw-Hunter
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
The United States ◽  
Traumatic Brain Injuries ◽  
Rehabilitation Counselors ◽  
Power Of Attorney ◽  
Injury Rehabilitation ◽  
The Individual

As the number of persons with traumatic brain injury has increased in the United States, the focus placed on whether or not guardianship is appropriate for such individuals has expanded. The purpose of this paper is to provide knowledge for rehabilitation counselors on the issues of guardianship and to explore other, less intrusive methods to meet the needs of individuals with traumatic brain injuries while maximizing their independence. Issues such as competency and independence need to be addressed in order to determine the necessity of guardianship. The level of restriction that guardianship imposes on the individual must also be considered in regards to what is most appropriate for the person with a traumatic brain injury, with consideration given to alternatives to guardianship that are less restrictive and invasive. Alternatives to guardianship include designating a representative payee, choosing a durable power of attorney, or creating a trust for the person with a traumatic brain injury. Rehabilitation counselors should be knowledgeable of the issues surrounding guardianship and alternatives to guardianship in order to have a strong knowledge base regarding issues that may affect their clients with traumatic brain injuries and to be able to provide the highest quality of services to their clients.

scholarly journals Traumatic Brain Injury in Sports: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Christopher S. Sahler ◽  
Brian D. Greenwald
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Brain Injury ◽  
Head Trauma ◽  
Brain Injuries ◽  
Cognitive Impairments ◽  
The United States ◽  
Neurological Dysfunction

Traumatic brain injury (TBI) is a clinical diagnosis of neurological dysfunction following head trauma, typically presenting with acute symptoms of some degree of cognitive impairment. There are an estimated 1.7 to 3.8 million TBIs each year in the United States, approximately 10 percent of which are due to sports and recreational activities. Most brain injuries are self-limited with symptom resolution within one week, however, a growing amount of data is now establishing significant sequelae from even minor impacts such as headaches, prolonged cognitive impairments, or even death. Appropriate diagnosis and treatment according to standardized guidelines are crucial when treating athletes who may be subjected to future head trauma, possibly increasing their likelihood of long-term impairments.

scholarly journals Pediatric Traumatic Brain Injury in the United States: Rural-Urban Disparities and Considerations

2020 ◽  
Vol 10 (3) ◽  
pp. 135 ◽  
Author(s):  
John K. Yue ◽  
Pavan S. Upadhyayula ◽  
Lauro N. Avalos ◽  
Tene A. Cage
Keyword(s):  
Mental Health ◽  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Healthcare Costs ◽  
Motor Vehicle ◽  
The United States ◽  
Pubmed Database ◽  
Pediatric Tbi

Introduction: Traumatic brain injury (TBI) remains a primary cause of pediatric morbidity. The improved characterization of healthcare disparities for pediatric TBI in United States (U.S.) rural communities is needed to advance care. Methods: The PubMed database was queried using keywords ((“brain/head trauma” OR “brain/head injury”) AND “rural/underserved” AND “pediatric/child”). All qualifying articles focusing on rural pediatric TBI, including the subtopics epidemiology (N = 3), intervention/healthcare cost (N = 6), and prevention (N = 1), were reviewed. Results: Rural pediatric TBIs were more likely to have increased trauma and head injury severity, with higher-velocity mechanisms (e.g., motor vehicle collisions). Rural patients were at risk of delays in care due to protracted transport times, inclement weather, and mis-triage to non-trauma centers. They were also more likely than urban patients to be unnecessarily transferred to another hospital, incurring greater costs. In general, rural centers had decreased access to mental health and/or specialist care, while the average healthcare costs were greater. Prevention efforts, such as mandating bicycle helmet use through education by the police department, showed improved compliance in children aged 5–12 years. Conclusions: U.S. rural pediatric patients are at higher risk of dangerous injury mechanisms, trauma severity, and TBI severity compared to urban. The barriers to care include protracted transport times, transfer to less-resourced centers, increased healthcare costs, missing data, and decreased access to mental health and/or specialty care during hospitalization and follow-up. Preventative efforts can be successful and will require an improved multidisciplinary awareness and education.

Traumatic Brain Injury: Mechanical Response of Porcine Brain Under High Strain Rate Tests

2009 ◽  
Author(s):  
Raj Prabhu ◽  
Mark Horstemeyer ◽  
Esteban Marin ◽  
Jun Liao ◽  
Matt Tucker ◽  
...  
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Mechanical Response ◽  
Motor Vehicle ◽  
The United States ◽  
Functional Changes ◽  
Mechanical Insult

The brain is one of the most critical organs of the human body during life-threatening and injury sustaining accidents. Traumatic brain injury (TBI) due to mechanical insult of the head is a leading cause of death and life-long disability in the United States. The Center for Disease Control (CDC) has estimated that, on average, 1.4 million Americans sustain TBI every year, 20% of which are the result of motor vehicle-traffic accidents. Nearly 50,000 people die of TBI each year. Around 5.3 million Americans currently have long-term disabilities after sustaining a TBI. Some of these long-term disabilities are linked to functional changes affecting thinking, sensation, language and emotions [1]. Direct and indirect medical costs related to TBI amounted to an estimated $60 billion in the United States in 2000 [2]. TBIs have a deep impact on our society and require effective protective measures to curb consequent injuries and disabilities [3].

scholarly journals Retroclival and spinal subdural hematoma after traumatic brain injury - A case report and literature review

2019 ◽  
Vol 10 ◽  
pp. 86 ◽  
Author(s):  
Saúl Solorio-Pineda ◽  
Adriana Ailed Nieves-Valerdi ◽  
José Alfonso Franco-Jiménez ◽  
Guillermo Axayacalt Gutiérrez-Aceves ◽  
Luis Manuel Buenrostro-Torres ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subdural Hematoma ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Traumatic Injury ◽  
Vascular Lesions ◽  
Vehicle Accidents ◽  
Spinal Subdural Hematoma

Background: Retroclival hematomas are rare and occur mostly in the pediatric population. They are variously attributed to trauma, apoplexy, and vascular lesions. With motor vehicle accidents (MVAs), the mechanism of traumatic injury is forced flexion and extension. There may also be associated cervical spinal and/or clivus fractures warranting fusion. Case Description: A 35-year-old male sustained a traumatic brain injury after a fall of 5 m at work. His Glasgow coma scale (GCS) on admission was 13 (M6V3O4). He had no cranial nerve deficits. The brain computed tomography (CT) showed a retroclival subdural hematoma that extended to the C2 level. Conclusions: Most retroclival hematomas are attributed to MVAs, and cranial CT and magnetic resonance studies typically demonstrate a combination of posterior fossa hemorrhage with retroclival hematomas (intra or extradural). Patients with retroclival hematomas but high GCS scores on admission usually have better prognoses following traumatic brain injuries attributed to MVA. Notable however is the frequent association with additional cervical and/or craniocervical injuries (e.g. such as odontoid fracture) that may warrant surgery/fusión.

scholarly journals Head Impact Injury Mitigation to Vehicle Occupants: An Investigation of Interior Padding and Head Form Modeling Options against Vehicle Crash

2021 ◽  
Author(s):  
Ermias G. Koricho ◽  
Elizabeth Dimsdale
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Impact Load ◽  
Age Groups ◽  
Vehicle Crash ◽  
Materials Modeling ◽  
Head Form ◽  
The Brain

Traumatic Brain Injuries (TBI) occur approximately 1.7 million times each year in the U.S., with motor vehicle crashes as the second leading cause of TBI-related hospitalizations, and the first leading cause of TBI-related deaths among specific age groups. Several studies have been conducted to better understand the impact on the brain in vehicle crash scenarios. However, the complexity of the head is challenging to replicate numerically the head response during vehicle crash and the resulting traumatic Brain Injury. Hence, this study aims to investigate the effect of vehicle structural padding and head form modeling representation on the head response and the resulting causation and Traumatic Brain Injury (TBI). In this study, a simplified and complex head forms with various geometries and materials including the skull, cerebrospinal fluid (CSF), neck, and muscle were considered to better understand and predict the behavior of each part and their effect on the response of the brain during an impact scenario. The effect of padding thickness was also considered to further analyze the interaction of vehicle structure and the head response. The numeral results revealed that the responses of the head skull and the brain under impact load were highly influenced by the padding thickness, head skull material modeling and assumptions, and neck compliance. Generally, the current work could be considered an alternative insight to understand the correlation between vehicle structural padding, head forms, and materials modeling techniques, and TBI resulted from a vehicle crash.

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.

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