Three-dimensional human head finite-element model validation against two experimental impacts

Computational modeling of human head under blast in confined and open spaces: primary blast injury

In this paper, a computational modeling for biomechanical analysis of primary blast injuries is presented. The responses of the brain in terms of mechanical parameters under different blast spaces including open, semi-confined, and confined environments are studied. In the study, the effect of direct and indirect blast waves from the neighboring walls in the confined environments will be taken into consideration. A 50th percentile finite element head model is exposed to blast waves of different intensities. In the open space, the head experiences a sudden intracranial pressure (ICP) change, which vanishes in a matter of a few milliseconds. The situation is similar in semi-confined space, but in the confined space, the reflections from the walls will create a number of subsequent peaks in ICP with a longer duration. The analysis procedure is based on a simultaneous interaction simulation of the deformable head and its components with the blast wave propagations. It is concluded that compared with the open and semi-confined space settings, the walls in the confined space scenario enhance the risk of primary blast injuries considerably because of indirect blast waves transferring a larger amount of damaging energy to the head.

Numerical model (switchable/dual model) of the human head for rigid body and finite elements applications

In this paper, a methodology for the development and validation of a numerical model of the human head using generic procedures is presented. All steps required, starting with the model generation, model validation and applications will be discussed. The proposed model may be considered as a dual one due to its capabilities to switch from deformable to a rigid body according to the application's requirements. The first step is to generate the numerical model of the human head using geometry files or medical images. The required stiffness and damping for the elastic connection used for the rigid body model are identified by performing a natural frequency analysis. The presented applications for model validation are related to impact analysis. The first case is related to Nahum's (Nahum and Smith 1970) experiments pressure data being evaluated and a pressure map generated using the results from discrete elements. For the second case, the relative displacement between the brain and the skull is evaluated according to Hardy's (Hardy WH, Foster CD, Mason, MJ, Yang KH, King A, Tashman S. 2001.Investigation of head injury mechanisms using neutral density technology and high-speed biplanar X-ray. Stapp Car Crash J. 45:337-368, SAE Paper 2001-22-0016) experiments. The main objective is to validate the rigid model as a quick and versatile tool for acquiring the input data for specific brain analyses.

Angular Impact Mitigation system for bicycle helmets to reduce head acceleration and risk of traumatic brain injury

Angular acceleration of the head is a known cause of traumatic brain injury (TBI), but contemporary bicycle helmets lack dedicated mechanisms to mitigate angular acceleration. A novel Angular Impact Mitigation (AIM) system for bicycle helmets has been developed that employs an elastically suspended aluminum honeycomb liner to absorb linear acceleration in normal impacts as well as angular acceleration in oblique impacts. This study tested bicycle helmets with and without AIM technology to comparatively assess impact mitigation. Normal impact tests were performed to measure linear head acceleration. Oblique impact tests were performed to measure angular head acceleration and neck loading. Furthermore, acceleration histories of oblique impacts were analyzed in a computational head model to predict the resulting risk of TBI in the form of concussion and diffuse axonal injury (DAI). Compared to standard helmets, AIM helmets resulted in a 14% reduction in peak linear acceleration (p<0.001), a 34% reduction in peak angular acceleration (p<0.001), and a 22-32% reduction in neck loading (p<0.001). Computational results predicted that AIM helmets reduced the risk of concussion and DAI by 27% and 44%, respectively. In conclusion, these results demonstrated that AIM technology could effectively improve impact mitigation compared to a contemporary expanded polystyrene-based bicycle helmet, and may enhance prevention of bicycle-related TBI. Further research is required.

Development of a Finite Element Human Head Model Partially Validated With Thirty Five Experimental Cases

This study is aimed to develop a high quality, extensively validated finite element (FE) human head model for enhanced head injury prediction and prevention. The geometry of the model was based on computed tomography (CT) and magnetic resonance imaging scans of an adult male who has the average height and weight of an American. A feature-based multiblock technique was adopted to develop hexahedral brain meshes including the cerebrum, cerebellum, brainstem, corpus callosum, ventricles, and thalamus. Conventional meshing methods were used to create the bridging veins, cerebrospinal fluid, skull, facial bones, flesh, skin, and membranes—including falx, tentorium, pia, arachnoid, and dura. The head model has 270,552 elements in total. Thirty five loading cases were selected from a range of experimental head impacts to check the robustness of the model predictions based on responses including the brain pressure, relative skull-brain motion, skull response, and facial response. The brain pressure was validated against intracranial pressure data reported by Nahum et al. (1977, “Intracranial Pressure Dynamics During Head Impact,” Proc. 21st Stapp Car Crash Conference, SAE Technical Paper No. 770922) and Trosseille et al. (1992, “Development of a F.E.M. of the Human Head According to a Specific Test Protocol,” Proc. 36th Stapp Car Crash Conference, SAE Technical Paper No. 922527). The brain motion was validated against brain displacements under sagittal, coronal, and horizontal blunt impacts performed by Hardy et al. (2001, “Investigation of Head Injury Mechanisms Using Neutral Density Technology and High-Speed Biplanar X-Ray,” Stapp Car Crash Journal, 45, pp. 337–368; and 2007, “A Study of the Response of the Human Cadaver Head to Impact,” Stapp Car Crash Journal, 51, pp. 17–80). The facial bone responses were validated under nasal impact (Nyquist et al. 1986, “Facial Impact Tolerance and Response,” Proc. 30th Stapp Car Crash Conference, SAE Technical Paper No. 861896), zygoma and maxilla impact (Allsop et al. 1988, “Facial Impact Response – A Comparison of the Hybrid III Dummy and Human Cadaver,” Proc. 32nd Stapp Car Crash Conference, SAE Technical Paper No. 881719)]. The skull bones were validated under frontal angled impact, vertical impact, and occipital impact (Yoganandan et al. 1995, “Biomechanics of Skull Fracture,” J Neurotrauma, 12(4), pp. 659–668) and frontal horizontal impact (Hodgson et al. 1970, “Fracture Behavior of the Skull Frontal Bone Against Cylindrical Surfaces,” 14th Stapp Car Crash Conference, SAE International, Warrendale, PA). The FE head model was further used to study injury mechanisms and tolerances for brain contusion (Nahum et al. 1976, “An Experimental Model for Closed Head Impact Injury,” 20th Stapp Car Crash Conference, SAE International, Warrendale, PA). Studies from 35 loading cases demonstrated that the FE head model could predict head responses which were comparable to experimental measurements in terms of pattern, peak values, or time histories. Furthermore, tissue-level injury tolerances were proposed. A maximum principal strain of 0.42% was adopted for skull cortical layer fracture and maximum principal stress of 20 MPa was used for skull diploë layer fracture. Additionally, a plastic strain threshold of 1.2% was used for facial bone fracture. For brain contusion, 277 kPa of brain pressure was calculated from reconstruction of one contusion case.

Brain response to primary blast wave using validated finite element models of human head and advanced combat helmet

Blast-induced traumatic brain injury has emerged as a “signature injury” in combat casualty care. Present combat helmets are designed primarily to protect against ballistic and blunt impacts, but the current issue with helmets is protection concerning blasts. In order to delineate the blast wave attenuating capability of the Advanced Combat Helmet (ACH), a finite element (FE) study was undertaken to evaluate the head response against blast loadings with and without helmet using a partially validated FE model of the human head and ACH. Four levels of overpressures (0.27–0.66 MPa) from the Bowen’s lung iso-damage threshold curves were used to simulate blast insults. Effectiveness of the helmet with respect to head orientation was also investigated. The resulting biomechanical responses of the brain to blast threats were compared for human head with and without the helmet. For all Bowen’s cases, the peak intracranial pressures (ICP) in the head ranged from 0.68 to 1.8 MPa in the coup cortical region. ACH was found to mitigate ICP in the head by 10–35%. Helmeted head resulted in 30% lower average peak brain strains and product of strain and strain rate. Among three blast loading directions with ACH, highest reduction in peak ICP (44%) was due to backward blasts whereas the lowest reduction in peak ICP and brain strains was due to forward blast (27%). The biomechanical responses of a human head to primary blast insult exhibited directional sensitivity owing to the different geometry contours and coverage of the helmet construction and asymmetric anatomy of the head. Thus, direction-specific tolerances are needed in helmet design in order to offer omni-directional protection for the human head. The blasts of varying peak overpressures and durations that are believed to produce the same level of lung injury produce different levels of mechanical responses in the brain, and hence “iso-damage” curves for brain injury are likely different than the Bowen curves for lung injury.

Mathematical Models of Blast-Induced TBI: Current Status, Challenges, and Prospects

Blast-induced traumatic brain injury (TBI) has become a signature wound of recent military activities and is the leading cause of death and long-term disability among U.S. soldiers. The current limited understanding of brain injury mechanisms impedes the development of protection, diagnostic, and treatment strategies. We believe mathematical models of blast wave brain injury biomechanics and neurobiology, complemented with in vitro and in vivo experimental studies, will enable a better understanding of injury mechanisms and accelerate the development of both protective and treatment strategies. The goal of this paper is to review the current state of the art in mathematical and computational modeling of blast-induced TBI, identify research gaps, and recommend future developments. A brief overview of blast wave physics, injury biomechanics, and the neurobiology of brain injury is used as a foundation for a more detailed discussion of multiscale mathematical models of primary biomechanics and secondary injury and repair mechanisms. The paper also presents a discussion of model development strategies, experimental approaches to generate benchmark data for model validation, and potential applications of the model for prevention and protection against blast wave TBI.

The validation and application of a finite element human head model for frontal skull fracture analysis

Traumatic head injuries can result from vehicular accidents, sports, falls or assaults. The current advances in computational methods and the detailed finite element models of the human head provide a significant opportunity for biomechanical study of human head injuries. The biomechanical characteristics of the human head through head impact scenarios can be studied in detail by using the finite element models. Skull fracture is one of the most frequent occurring types of head injuries. The purpose of this study is to analyse the experimental head impacts on cadavers by means of the Strasbourg University Finite Element Head Model (SUFEHM). The results of the numerical model and experimental data are compared for validation purpose. The finite element model has also been applied to predict the skull bone fracture in frontal impacts. The head model includes the scalp, the facial bone, the skull, the cerebral spinal fluid, the meninges, the cerebrum and the cerebellum. The model is used to simulate the experimental frontal head impact tests using a cylindrical padded impactor. Results of the computational simulation shows that the model correlated well with a number of experimental data and a global fracture pattern has been predicted well by the model. Therefore the presented numerical model could be used for reconstruction of head impacts in different impact conditions also the forensic application of the head model would provide a tool for investigation of the causes and mechanism of head injuries.

Mechanics of blast loading on the head models in the study of traumatic brain injury using experimental and computational approaches

Blast waves generated by improvised explosive devices can cause mild, moderate to severe traumatic brain injury in soldiers and civilians. To understand the interactions of blast waves on the head and brain and to identify the mechanisms of injury, compression-driven air shock tubes are extensively used in laboratory settings to simulate the field conditions. The overall goal of this effort is to understand the mechanics of blast wave-head interactions as the blast wave traverses the head/brain continuum. Toward this goal, surrogate head model is subjected to well-controlled blast wave profile in the shock tube environment, and the results are analyzed using combined experimental and numerical approaches. The validated numerical models are then used to investigate the spatiotemporal distribution of stresses and pressure in the human skull and brain. By detailing the results from a series of careful experiments and numerical simulations, this paper demonstrates that: (1) Geometry of the head governs the flow dynamics around the head which in turn determines the net mechanical load on the head. (2) Biomechanical loading of the brain is governed by direct wave transmission, structural deformations, and wave reflections from tissue-material interfaces. (3) Deformation and stress analysis of the skull and brain show that skull flexure and tissue cavitation are possible mechanisms of blast-induced traumatic brain injury.

Finite-element study of cerebrospinal fluid in mitigating closed head injuries

The mechanism of cerebrospinal fluid in mitigating closed head injuries caused by mild impacts was investigated by finite-element modeling. Three biomechanical models were constructed. In these models, cerebrospinal fluid was considered as a soft solid material, an inviscid fluid without intracranial pressure, and an inviscid fluid with normal intracranial pressure, respectively, while other conditions such as the finite-element mesh, the impact, and the boundary conditions were kept the same. The recently developed nearest nodes finite-element method was adopted to deal with large deformations in brain tissue. Results obtained from the numerical studies showed that cerebrospinal fluid was able to remarkably reduce the maximum peak strains, especially the shear strains induced by impacts and transmitted to the brain. Cerebrospinal fluid with intracranial pressure was able to further buffer relative oscillations between the skull and the brain.

BRAIN MOTION AND DEFORMATION DURING CLOSED HEAD INJURY IN THE PRESENCE OF CEREBROSPINAL FLUID

This paper presents a new analysis of the physics of closed head injury following brief, intense acceleration of the head. It focuses upon the buoyancy of the brain in cerebrospinal fluid, which protects against damage; the propagation of strain waves through the brain substance, which causes damage; and the concentration of strain in critical anatomic regions, which magnifies damage. Numerical methods are used to create animations or "movies" of brain motion and deformation. Initially, a 1 cm gap filled with cerebrospinal fluid (CSF) separates the brain from the skull. Whole head acceleration induces artificial gravity within the skull. The brain accelerates, because its density differs slightly from that of CSF, strikes the inner aspect of the skull, and then undergoes viscoelastic deformation. The computed pattern of brain motion correlates well with published high-speed photographic studies. The sites of greatest deformation correlate with sites of greatest pathological damage. This fresh biomechanical analysis allows one to visualize events within the skull during closed head injury and may inspire new approaches to prevention and treatment.

Computational model of an infant brain subjected to periodic motion simplified modelling and bayesian sensitivity analysis

Non-accidental head injury in infants, or shaken baby syndrome, is a highly controversial and disputed topic. Biomechanical studies often suggest that shaking alone cannot cause the classical symptoms, yet many medical experts believe the contrary. Researchers have turned to finite element modelling for a more detailed understanding of the interactions between the brain, skull, cerebrospinal fluid (CSF), and surrounding tissues. However, the uncertainties in such models are significant; these can arise from theoretical approximations, lack of information, and inherent variability. Consequently, this study presents an uncertainty analysis of a finite element model of a human head subject to shaking. Although the model geometry was greatly simplified, fluid-structure-interaction techniques were used to model the brain, skull, and CSF using a Eulerian mesh formulation with penalty-based coupling. Uncertainty and sensitivity measurements were obtained using Bayesian sensitivity analysis, which is a technique that is relatively new to the engineering community. Uncertainty in nine different model parameters was investigated for two different shaking excitations: sinusoidal translation only, and sinusoidal translation plus rotation about the base of the head. The level and type of sensitivity in the results was found to be highly dependent on the excitation type.

Mechanical characterization and optoelectronic measurement of parietal bone thickness before and after monocortical bone graft harvest: design and validation of a test protocol

Parietal bone grafts are commonly used in craniomaxillofacial surgery. However, bone removal may weaken the parietal bone and lead to deleterious complications. The aim of our study was to design a test protocol for characterization of the impact resistance of parietal bone before and after monocortical bone graft harvest and to validate an optoelectronic measurement of parietal bone thickness. Twelve fresh human cadaver heads were used for the validation study. To evaluate impact resistance, we developed a pendulum Charpy impact testing machine. The impact force was gradually increased until failure (fracture) of the defined parietal bone area. According to the protocol, we measured the maximum absorbable energy or impact force to failure. With our test setup, measurement of the impact resistance of parietal bone was accurate to within 0.025 J. We defined a range of values and particularly a threshold value. The initial maximal impact must not to exceed 4 J. For more accuracy, we compared 5 nondestructive measurement methods using a surgical navigation system with optoelectronic tracking. We achieved an algorithm based on 2 methods that ensured a measurement resolution of 0.1 mm. Validation of this protocol will allow us to evaluate the loss of strength resulting from bone removal and the correlation between strength and thickness of the parietal bone.

A finite element method parametric study of the dynamic response of the human brain with different cerebrospinal fluid constitutive properties

A major role for the cerebrospinal fluid (CSF) is to provide effective damping against sudden intracranial brain motions during dynamic head impact. This paper examines the roles of CSF properties on human brain responses under certain impact loadings. The brain is assumed to have a hyperviscoelastic material behaviour, while CSF is considered to be fluid-like elastic, viscoelastic, and nearly incompressible elastic with a low shear modulus and a high bulk modulus. A finite element parametric investigation on a head model under different scenarios of impact is conducted. In the study, the CSF material parameters are varied within the expected range of change, while other components of the head model are kept constant. The results indicate that the solutions from the modelling of CSF by a fluid-like medium are more realistic and support the findings of the experiment. The results also indicate that varying CSF properties did not have a major impact on the peak intracranial pressures but the impact on brain principal and shear strains are relatively significant. A sizeable impact on the relative motion of the brain, with respect to the skull, can also be observed.

Assessment of head injury of children due to golf ball impact

Head trauma injury due to impact by a flying golf ball is one of the most severe possible injury accidents on the golf course. Numerical simulations based on the finite element method are presented to investigate head injury in children due to impact by a flying golf ball. The stress and energy flow patterns in a head model during the golf ball impact are computed for various combinations of striking speed, falling angle of the golf ball before impact, and impact location. It is found that a child is more prone to head injury due to golf ball impact on the frontal and side/temporal areas. The simulated results are found to conform to the clinical reports on children's head injuries from flying golf balls.

Biomechanical assessment of brain dynamic responses due to blast pressure waves

A mechanized and integrated computational scheme is introduced to determine the human brain responses in an environment where the human head is exposed to explosions from trinitrotoluene (TNT), or other high-yield explosives, in military applications. The procedure is based on a three-dimensional (3-D) non-linear finite element method (FEM) that implements a simultaneous conduction of explosive detonation, shock wave propagation, blast-head interactions, and the confronting human head. The processes of blast propagation in the air and blast interaction with the head are modeled by an Arbitrary Lagrangian-Eulerian (ALE) multi-material FEM formulation, together with a penalty-based fluid/structure interaction (FSI) algorithm. Such a model has already been successfully validated against experimental data regarding air-free blast and plate-blast interactions. The human head model is a 3-D geometrically realistic configuration that has been previously validated against the brain intracranial pressure (ICP), as well as shear and principal strains under different impact loadings of cadaveric experimental tests of Hardy et al. [Hardy W. N., C. Foster, M. Mason, S. Chirag, J. Bishop, M. Bey, W. Anderst, and S. Tashman. A study of the response of the human cadaver head to impact. Proc. 51 ( st ) Stapp. Car Crash J. 17-80, 2007]. Different scenarios have been assumed to capture an appropriate picture of the brain response at a constant stand-off distance of nearly 80 cm from the core of the explosion, but exposed to different amounts of a highly explosive (HE) material such as TNT. The over-pressures at the vicinity of the head are in the range of about 2.4-8.7 atmosphere (atm), considering the reflected pressure from the head. The methodology provides brain ICP, maximum shear stresses and maximum principal strain within the milli-scale time frame of this highly dynamic phenomenon. While focusing on the two mechanical parameters of pressure, and also on the maximum shear stress and maximum principal strain to predict the brain injury, the research provides an assessment of the brain responses to different amounts of over-pressure. The research also demonstrates the ability to predict the ICP, as well as the stress and strain within the brain, due to such an event. The research cannot identify, however, the specific levels of ICP, stress and strain that necessarily lead to traumatic brain injury (TBI) because there is no access to experimental data regarding head-blast interactions.

Simulation of Blast-Induced Early-Time Intracranial Wave Physics leading to Traumatic Brain Injury

The objective of this modeling and simulation study was to establish the role of stress wave interactions in the genesis of traumatic brain injury (TBI) from exposure to explosive blast. A high resolution (1 mm3 voxels) five material model of the human head was created by segmentation of color cryosections from the Visible Human Female data set. Tissue material properties were assigned from literature values. The model was inserted into the shock physics wave code, CTH, and subjected to a simulated blast wave of 1.3 MPa (13 bars) peak pressure from anterior, posterior, and lateral directions. Three-dimensional plots of maximum pressure, volumetric tension, and deviatoric (shear) stress demonstrated significant differences related to the incident blast geometry. In particular, the calculations revealed focal brain regions of elevated pressure and deviatoric stress within the first 2 ms of blast exposure. Calculated maximum levels of 15 KPa deviatoric, 3.3 MPa pressure, and 0.8 MPa volumetric tension were observed before the onset of significant head accelerations. Over a 2 ms time course, the head model moved only 1 mm in response to the blast loading. Doubling the blast strength changed the resulting intracranial stress magnitudes but not their distribution. We conclude that stress localization, due to early-time wave interactions, may contribute to the development of multifocal axonal injury underlying TBI. We propose that a contribution to traumatic brain injury from blast exposure, and most likely blunt impact, can occur on a time scale shorter than previous model predictions and before the onset of linear or rotational accelerations traditionally associated with the development of TBI.

Proxy-based Sliding Mode Control of a Planar Pneumatic Manipulator

For a robotic system that shares its workspace with humans and physically interacts with them, safety is of paramount importance. In order to build a safe system, safety has to be considered in both hardware and software (control). In this paper, we present the safe control of a two-degree-of-freedom planar manipulator actuated by Pleated Pneumatic Artificial Muscles. Owing to its low weight and inherent compliance, the system hardware has excellent safety characteristics. In traditional control methods, safety and good tracking are often impossible to combine. This is different in the case of Proxy-Based Sliding Mode Control (PSMC), a novel control method introduced by Kikuuwe and Fujimoto. PSMC combines responsive and accurate tracking during normal operation with smooth, slow and safe recovery from large position errors. It can also make the system behave compliantly to external disturbances. We present both task- and joint-space implementations of PSMC applied to the pneumatic manipulator, and compare their performance with PID control. Good tracking results are obtained, especially with the joint-space implementation. Safety is evaluated by means of the Head Injury Criterion and by the maximum interaction force in the case of collision. It is found that in spite of the hardware safety features, the system is unsafe when under PID control. PSMC, on the other hand, provides increased safety as well as good tracking.

Biofidelic child head FE model to simulate real world trauma

Biomechanics of human head has been widely studied since several decades. At a mechanical level, the use of engineering allowed investigating injury mechanisms developing numerical models of adult head. For children, the problem is more difficult and evaluating child injury mechanisms using data obtained from scaling adult injury criteria does not account for differences in morphology and structure between adults and children. During growth, child head undergoes different modifications in morphology and structure. The present paper compares the anthropometry and numerical simulations of a child head model based on medical CT scans to a child head model developed by scaling an adult head model using the method proposed by Mertz [H.J. Mertz, A procedure for normalizing impact response data, SAE paper 840884, 1984]. These analysis point out significant differences showing that scaling down an adult head to obtain a child head does not appear relevant. Biofidelic and specific child geometry is needed to investigate child injury mechanisms.

Biomechanics of traumatic brain injury: influences of the morphologic heterogeneities of the cerebral cortex

Traumatic brain injury (TBI) can be caused by accidents and often leads to permanent health issues or even death. Brain injury criteria are used for assessing the probability of TBI, if a certain mechanical load is applied. The currently used injury criteria in the automotive industry are based on global head kinematics. New methods, based on finite element modeling, use brain injury criteria at lower scale levels, e.g., tissue-based injury criteria. However, most current computational head models lack the anatomical details of the cerebrum. To investigate the influence of the morphologic heterogeneities of the cerebral cortex, a numerical model of a representative part of the cerebral cortex with a detailed geometry has been developed. Several different geometries containing gyri and sulci have been developed for this model. Also, a homogeneous geometry has been made to analyze the relative importance of the heterogeneities. The loading conditions are based on a computational head model simulation. The results of this model indicate that the heterogeneities have an influence on the equivalent stress. The maximum equivalent stress in the heterogeneous models is increased by a factor of about 1.3-1.9 with respect to the homogeneous model, whereas the mean equivalent stress is increased by at most 10%. This implies that tissue-based injury criteria may not be accurately applied to most computational head models used nowadays, which do not account for sulci and gyri.

Head injury prediction capability of the HIC, HIP, SIMon and ULP criteria

The objective of the present study is to synthesize and investigate using the same set of sixty-one real-world accidents the human head injury prediction capability of the head injury criterion (HIC) and the head impact power (HIP) based criterion as well as the injury mechanisms related criteria provided by the simulated injury monitor (SIMon) and the Louis Pasteur University (ULP) finite element head models. Each accident has been classified according to whether neurological injuries, subdural haematoma and skull fractures were reported. Furthermore, the accidents were reconstructed experimentally or numerically in order to provide loading conditions such as acceleration fields of the head or initial head impact conditions. Finally, thanks to this large statistical population of head trauma cases, injury risk curves were computed and the corresponding regression quality estimators permitted to check the correlation of the injury criteria with the injury occurrences. As different kinds of accidents were used, i.e. footballer, motorcyclist and pedestrian cases, the case-independency could also be checked. As a result, FE head modeling provides essential information on the intracranial mechanical behavior and, therefore, better injury criteria can be computed. It is clearly shown that moderate and severe neurological injuries can only be distinguished with a criterion that is computed using intracranial variables and not with the sole global head acceleration.

Dynamic response of a human head to a foreign object impact

This paper presents an analysis of a human head response to impact by a foreign object. The analysis is accomplished via an integration of a head-striker contact force function with a 3-D finite-element (FE) head model. The contact force function developed by the authors is used to estimate the contact force between the solid striker and the human head. An explicit FE solver, implemented with the contact force function, is employed to predict the human head response to the contact impact. The analysis is verified by comparing the present results with the experimental data published by others. Based on the present solution, the effects of the different impact conditions on the intracranial pressure of the head are investigated.

Region-specific tolerance criteria for the living brain

Computational models of traumatic brain injury (TBI) can predict injury-induced brain deformation. However, predicting the biological consequences (i.e. cell death or dysfunction) of induced brain deformation requires tolerance criteria. Here, we present a tolerance criterion for the cortex which exhibits important differences from that of the hippocampus. Organotypic slice cultures of the rat cortex, which maintain tissue architecture and cell content consistent with that in vivo, were mechanically injured with an in vitro model described previously. Cultures were stretched equibiaxially up to 0.35 Lagrangian strain at strain rates up to 50 s(-1). Cell death was quantified at 1, 2, 3, and 4 days following injury. Statistical analysis (repeated measures ANOVA) showed that all three factors (Strain, Strain Rate, and Time post-injury) significantly affected cell death. An equation describing cell death as a function of the significant parameters was then fit to the data. Compared to the hippocampus, the cortex was less vulnerable to stretch-induced injury and demonstrated a strain threshold below 0.20. Strain rate was also a significant factor for cortical but not hippocampal cell death. Cortical cell death began at an earlier time point than in the hippocampus, with cell death evident at 1 day post-injury versus 3 days in the hippocampus. In conclusion, different regions of the brain respond differently to identical mechanical stimuli, and this difference should be incorporated into finite element models of TBI if they are to more accurately predict in vivo consequences of TBI.

Parametric study of head impact in the infant

Computer finite element model (FEM) simulations are often used as a substitute for human experimental head injury studies to enhance our understanding of injury mechanisms and develop prevention strategies. While numerous adult FEM of the head have been developed, there are relatively few pediatric FEM due to the paucity of material property data for children. Using radiological serial images of infants (<6 wks old) and recent published material property data of infant skull and suture, we developed a FEM of the infant head to study skull fracture from occipital impacts. Here we determined the relative importance of brain material properties and anatomical variations in infant suture and scalp tissue on principal stress (sigma(p)) estimates in the skull of the model using parametric simulations of occipital impacts from 0.3m falls onto concrete. Decreasing the brain stiffness of pediatric brain tissue by a factor of two to simulate the softer adult brain properties we reported previously did not affect sigma(p). Using adult brain stiffness reported by others (4 times higher than our pediatric values) increased sigma(p) in skull by 38%. Interestingly, the precision used to model compressibility of the brain (0.49-0.4999) significantly varied sigma(p) 30-77%, underscoring the influence of the brain properties in models of fracture in the highly deformable infant skullcase. Suture thickness, small anatomical variations in suture width and the exclusion of scalp did not affect sigma(p) of the skull; however, unusually large sutures (10 mm) in young infants significantly lowered sigma(p). Validation of this model against published infant cadaver drop studies found good agreement with the prediction of fracture for falls onto hard surfaces. More biomechanical data from impacts onto softer surfaces is needed before skull fracture predictions can be made in these scenarios. In summary, the pediatric FEM response is not sensitive to small variations in anatomy or brain modulus, large deviations will significantly influence principal stress estimates and the prediction of skull fracture.

Effects of head size and morphology on dynamic responses to impact loading

Head responses subjected to impact loading are studied using the finite element method. The dynamic responses of the stress, strain, strain energy density and the intracranial pressure govern the intracranial tissues and skull material failures, and therefore, the traumatic injuries. The objectivity and consistency of the prevailing head traumatic injury criteria, i.e., the energy absorption, the gravity centre acceleration and the head injury criterion (HIC), are examined with regard to the head dynamic responses. In particular, the structural intensity (STI) (the vector representation of energy flow rate) is calculated and discussed. From the simulations, the STI, instead of the gravity centre acceleration, the HIC and the energy absorption criteria, is found to be consistent with the dynamic response quantities. The different local skull curvatures at impact have a marginal effect whereas the locations of the impact loadings have significant effects on the dynamics responses or the head injury. The STI also shows the failure patterns.

An approach for the estimation of contact force on a human head induced by a foreign-object impact

This paper presents a novel approach to estimate the contact force on a human head induced by a foreign-object impact. A simple head-striker model is proposed to describe the contact between the human head and the foreign-object striker. Based on the head-striker model, a contact force function is formulated, which is expressed by the head and striker material properties and the impact velocity. The contact force predicted by present method is compared with the previous published experimental data. A good agreement of the simulation results with the experimental data shows the feasibility of the present approach.

Snoring source identification and snoring noise prediction

This paper investigates the snoring mechanism of humans by applying the concept of structural intensity to a three-dimensional (3D) finite element model of a human head, which includes: the upper part of the head, neck, soft palate, hard palate, tongue, nasal cavity and the surrounding walls of the pharynx. Results show that for 20, 40 and 60Hz pressure loads, tissue vibration is mainly in the areas of the soft palate, the tongue and the nasal cavity. For predicting the snoring noise level, a 3D boundary element cavity model of the upper airway in the nasal cavity is generated. The snoring noise level is predicted for a prescribed airflow loading, and its range agrees with published measurements. These models may be further developed to study the various snoring mechanisms for different groups of patients.

A three-dimensional human head finite element model and power flow in a human head subject to impact loading

A three-dimensional finite element model of the human head is presented. The model has been validated against two sets of experimental results. To assess injury likelihood of the head subjected to impact loading, the structural intensity (SI) methodology is introduced in accordance with the prevailing practice in experimental biomechanics. SI is a vector quantity indicating the direction and magnitude of power flow inside a dynamically loaded structure. In this paper, the SI field inside the head model is computed for three cases, namely frontal, rear and side impacts. The results for the three cases have revealed that there exist power flow paths. The skull is, in general, a good energy flow channel. The study has also revealed the high possibility of spinal cord injury due to wave motion inside the head.

Concussion in Professional Football: Brain Responses by Finite Element Analysis: Part 9

OBJECTIVE

Brain responses from concussive impacts in National Football League football games were simulated by finite element analysis using a detailed anatomic model of the brain and head accelerations from laboratory reconstructions of game impacts. This study compares brain responses with physician determined signs and symptoms of concussion to investigate tissue-level injury mechanisms.

METHODS

The Wayne State University Head Injury Model (Version 2001) was used because it has fine anatomic detail of the cranium and brain with more than 300,000 elements. It has 15 different material properties for brain and surrounding tissues. The model includes viscoelastic gray and white brain matter, membranes, ventricles, cranium and facial bones, soft tissues, and slip interface conditions between the brain and dura. The cranium of the finite element model was loaded by translational and rotational accelerations measured in Hybrid III dummies from 28 laboratory reconstructions of NFL impacts involving 22 concussions. Brain responses were determined using a nonlinear, finite element code to simulate the large deformation response of white and gray matter. Strain responses occurring early (during impact) and mid-late (after impact) were compared with the signs and symptoms of concussion.

RESULTS

Strain concentration "hot spots" migrate through the brain with time. In 9 of 22 concussions, the early strain "hot spots" occur in the temporal lobe adjacent to the impact and migrate to the far temporal lobe after head acceleration. In all cases, the largest strains occur later in the fornix, midbrain, and corpus callosum. They significantly correlated with removal from play, cognitive and memory problems, and loss of consciousness. Dizziness correlated with early strain in the orbital-frontal cortex and temporal lobe. The strain migration helps explain coup-contrecoup injuries.

CONCLUSION

Finite element modeling showed the largest brain deformations occurred after the primary head acceleration. Midbrain strain correlated with memory and cognitive problems and removal from play after concussion. Concussion injuries happen during the rapid displacement and rotation of the cranium, after peak head acceleration and momentum transfer in helmet impacts.

Influence of the lateral ventricles and irregular skull base on brain kinematics due to sagittal plane head rotation

Two-dimensional physical models of the human head were used to investigate how the lateral ventricles and irregular skull base influence kinematics in the medial brain during sagittal angular head dynamics. Silicone gel simulated the brain and was separatedfrom the surrounding skull vessel by paraffin that provided a slip interface between the gel and vessel. A humanlike skull base model (HSB) included a surrogate skull base mimicking the irregular geometry of the human. An HSBV model added an elliptical inclusion filled with liquid paraffin simulating the lateral ventricles to the HSB model. A simplified skull base model (SSBV) included ventricle substitute but approximated the anterior and middle cranial fossae by a flat and slightly angled surface. The models were exposed to 7600 rad/s2 peak angular acceleration with 6 ms pulse duration and 5 deg forced rotation. After 90 deg free rotation, the models were decelerated during 30 ms. Rigid body displacement, shear strain and principal strains were determined from high-speed video recorded trajectories of grid markers in the surrogate brains. Peak values of inferior brain surface displacement and strains were up to 10.9X (times) and 3.3X higher in SSBV than in HSBV. Peak strain was up to 2.7X higher in HSB than in HSBV. The results indicate that the irregular skull base protects nerves and vessels passing through the cranial floor by reducing brain displacement and that the intraventricular cerebrospinal fluid relieves strain in regions inferior and superior to the ventricles. The ventricles and irregular skull base are necessary in modeling head impact and understanding brain injury mechanisms.

Consequences of head size following trauma to the human head

The objective of the present study was to evaluate whether variation of human head size results in different outcome regarding intracranial responses following a direct impact. Finite Element models representing different head sizes and with various element mesh densities were created. Frontal impacts towards padded surfaces as well as inertial loads were analyzed. The variation in intracranial stresses and intracranial pressures for different sizes of the geometry and for various element meshes were investigated. A significant correlation was found between experiment and simulation with regard to intracranial pressure characteristics. The maximal effective stresses in the brain increased more than a fourfold, from 3.6kPa for the smallest head size to 16.3kPa for the largest head size using the same acceleration impulse. When simulating a frontal impact towards a padding, the head injury criterion (HIC) value varies from the highest level of 2433 at a head mass of 2.34kg to the lowest level of 1376 at a head mass of 5.98kg, contradicting the increase in maximal intracranial stresses with head size. The conclusion is that the size dependence of the intracranial stresses associated with injury, is not predicted by the HIC. It is suggested that variations in head size should be considered when developing new head injury criteria.

Recent advances in brain injury research: a new human head model development and validation

Many finite element models have been developed by several research groups in order to achieve a better understanding of brain injury. Due to the lack of experimental data, validation of these models has generally been limited. Consequently, applying these models to investigate brain responses has also been limited. Over the last several years, several versions of the Wayne State University brain injury model (WSUBIM) were developed. However, none of these models is capable of simulating indirect impacts with an angular acceleration higher than 8,000 rad/s(2). Additionally, the density and quality of the mesh in the regions of interest are not detailed and sensitive enough to accurately predict the stress/strain level associated with a wide range of impact severities. In this study, WSUBIM version 2001, capable of simulating direct and indirect impacts with a combined translational and rotational acceleration of the head up to 200 g and 12,000 rad/s(2) has been developed. This new finely meshed model, consisting of more than 314,500 elements and 281,800 nodes, also simulates an anatomically detailed facial bone model. An additional new feature of the model is the damageable material property representation of the facial bone and the skull, allowing it to simulate bony fractures. The model was subjected to extensive validation using published cadaveric test data. These data include the intracranial and ventricular pressure data reported by Nahum et al. (1977) and Trosseille et al. (1992), the relative displacement data between the brain and the skull reported by King et al. (1999) and Hardy et al. (2001), and the facial impact data reported by Nyquist et al. (1986) and Allsop et al. (1988). With the enhanced accuracy of model predictions offered by this new model, along with new experimental data, it is hoped that it will become a powerful tool to further our understanding of the mechanisms of injury and the tolerance of the brain to blunt impact.

Leeches for the unfortunate locksmith: self-inflicted posttraumatic transient cerebral blindness--mode of treatment and underlying mechanism (1826)

In 1826, Jean-Pierre Gama, a French military surgeon, treated a young locksmith who had self-inflicted posttraumatic transient cortical blindness. This may be the earliest detailed, firsthand description of this condition by a medically and scientifically trained observer. Gama's report sheds light on the concept of the mechanism of coup-contrecoup of cerebral concussion and its treatment in the early 19th century and on the germinating discipline of cerebral localization.