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Delteil C, Manlius T, Bailly N, Godio-Raboutet Y, Piercecchi-Marti MD, Tuchtan L, Hak JF, Velly L, Simeone P, Thollon L. Traumatic axonal injury: Clinic, forensic and biomechanics perspectives. Leg Med (Tokyo) 2024; 70:102465. [PMID: 38838409 DOI: 10.1016/j.legalmed.2024.102465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/21/2024] [Accepted: 06/01/2024] [Indexed: 06/07/2024]
Abstract
Identification of Traumatic axonal injury (TAI) is critical in clinical practice, particularly in terms of long-term prognosis, but also for medico-legal issues, to verify whether the death or the after-effects were attributable to trauma. Multidisciplinary approaches are an undeniable asset when it comes to solving these problems. The aim of this work is therefore to list the different techniques needed to identify axonal lesions and to understand the lesion mechanisms involved in their formation. Imaging can be used to assess the consequences of trauma, to identify indirect signs of TAI, to explain the patient's initial symptoms and even to assess the patient's prognosis. Three-dimensional reconstructions of the skull can highlight fractures suggestive of trauma. Microscopic and immunohistochemical techniques are currently considered as the most reliable tools for the early identification of TAI following trauma. Finite element models use mechanical equations to predict biomechanical parameters, such as tissue stresses and strains in the brain, when subjected to external forces, such as violent impacts to the head. These parameters, which are difficult to measure experimentally, are then used to predict the risk of injury. The integration of imaging data with finite element models allows researchers to create realistic and personalized computational models by incorporating actual geometry and properties obtained from imaging techniques. The personalization of these models makes their forensic approach particularly interesting.
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Affiliation(s)
- Clémence Delteil
- Forensic Department, Assistance Publique-Hôpitaux de Marseille, La Timone, 264 rue St Pierre, 13385 Marseille Cedex 05, France; Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | - Thais Manlius
- Aix Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.
| | - Nicolas Bailly
- Aix Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France; Neuroimagery Department, Assistance Publique-Hôpitaux de Marseille, La Timone, 264 rue St Pierre, 13385 Marseille Cedex 05, France.
| | | | - Marie-Dominique Piercecchi-Marti
- Forensic Department, Assistance Publique-Hôpitaux de Marseille, La Timone, 264 rue St Pierre, 13385 Marseille Cedex 05, France; Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | - Lucile Tuchtan
- Forensic Department, Assistance Publique-Hôpitaux de Marseille, La Timone, 264 rue St Pierre, 13385 Marseille Cedex 05, France; Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | | | - Lionel Velly
- Département d'Anesthésie-Réanimation, Assistance Publique-Hôpitaux de Marseille, La Timone, Marseille, France; Université Aix-Marseille/CNRS, Institut des Neurosciences de la Timone, UMR7289, Marseille, France.
| | - Pierre Simeone
- Département d'Anesthésie-Réanimation, Assistance Publique-Hôpitaux de Marseille, La Timone, Marseille, France; Université Aix-Marseille/CNRS, Institut des Neurosciences de la Timone, UMR7289, Marseille, France.
| | - Lionel Thollon
- Aix Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.
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Seeburrun T, Bustamante MC, Hartlen DC, Azar A, Ouellet S, Cronin DS. Assessment of brain response in operators subject to recoil force from firing long-range rifles. Front Bioeng Biotechnol 2024; 12:1352387. [PMID: 38419729 PMCID: PMC10899685 DOI: 10.3389/fbioe.2024.1352387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Mild traumatic brain injury (mTBI) may be caused by occupational hazards military personnel encounter, such as falls, shocks, exposure to blast overpressure events, and recoil from weapon firing. While it is important to protect against injurious head impacts, the repeated exposure of Canadian Armed Forces (CAF) service members to sub-concussive events during the course of their service may lead to a significant reduction in quality of life. Symptoms may include headaches, difficulty concentrating, and noise sensitivity, impacting how personnel complete their duties and causing chronic health issues. This study investigates how the exposure to the recoil force of long-range rifles results in head motion and brain deformation. Direct measurements of head kinematics of a controlled population of military personnel during firing events were obtained using instrumented mouthguards. The experimentally measured head kinematics were then used as inputs to a finite element (FE) head model to quantify the brain strains observed during each firing event. The efficacy of a concept recoil mitigation system (RMS), designed to mitigate loads applied to the operators was quantified, and the RMS resulted in lower loading to the operators. The outcomes of this study provide valuable insights into the magnitudes of head kinematics observed when firing long-range rifles, and a methodology to quantify effects, which in turn will help craft exposure guidelines, guide training to mitigate the risk of injury, and improve the quality of lives of current and future CAF service members and veterans.
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Affiliation(s)
- Tanvi Seeburrun
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Michael C Bustamante
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Devon C Hartlen
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Austin Azar
- Valcartier Research Centre, Defence Research and Development Canada, Quebec, QC, Canada
| | - Simon Ouellet
- Valcartier Research Centre, Defence Research and Development Canada, Quebec, QC, Canada
| | - Duane S Cronin
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
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Nocera A, Sbrollini A, Romagnoli S, Morettini M, Gambi E, Burattini L. Physiological and Biomechanical Monitoring in American Football Players: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:3538. [PMID: 37050597 PMCID: PMC10098592 DOI: 10.3390/s23073538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 06/19/2023]
Abstract
American football is the sport with the highest rates of concussion injuries. Biomedical engineering applications may support athletes in monitoring their injuries, evaluating the effectiveness of their equipment, and leading industrial research in this sport. This literature review aims to report on the applications of biomedical engineering research in American football, highlighting the main trends and gaps. The review followed the PRISMA guidelines and gathered a total of 1629 records from PubMed (n = 368), Web of Science (n = 665), and Scopus (n = 596). The records were analyzed, tabulated, and clustered in topics. In total, 112 studies were selected and divided by topic in the biomechanics of concussion (n = 55), biomechanics of footwear (n = 6), biomechanics of sport-related movements (n = 6), the aerodynamics of football and catch (n = 3), injury prediction (n = 8), heat monitoring of physiological parameters (n = 8), and monitoring of the training load (n = 25). The safety of players has fueled most of the research that has led to innovations in helmet and footwear design, as well as improvements in the understanding and prevention of injuries and heat monitoring. The other important motivator for research is the improvement of performance, which has led to the monitoring of training loads and catches, and studies on the aerodynamics of football. The main gaps found in the literature were regarding the monitoring of internal loads and the innovation of shoulder pads.
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