Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0–3 YO population. In this study, head CT scans from fifty-six 0–3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.
In this study, a statistical model of cranium geometry for 0- to 3-month-old children was developed by analyzing 11 CT scans using a combination of principal component analysis and multivariate regression analysis. Radial basis function was used to morph the geometry of a baseline child head finite element (FE) model into models with geometries representing a newborn, a 1.5-month-old, and a 3-month-old infant head. These three FE models were used in a parametric study of near-vertex impact conditions to quantify the sensitivity of different material parameters. Finally, model validation was conducted against peak head accelerations in cadaver tests under different impact conditions, and optimization techniques were used to determine the material properties. The results showed that the statistical model of cranium geometry produced realistic cranium size and shape, suture size, and skull/suture thickness, for 0- to 3-month-old children. The three pediatric head models generated by morphing had mesh quality comparable to the baseline model. The elastic modulus of skull had a greater effect on most head impact response measurements than other parameters. Head geometry was a significant factor affecting the maximal principal stress of the skull (p = 0.002) and maximal principal strain of the suture (p = 0.021) after controlling for the skull material. Compared with the newborn head, the 3-month-old head model produced 6.5% higher peak head acceleration, 64.8% higher maximal principal stress, and 66.3% higher strain in the suture. However, in the skull, the 3-month-old model produced 25.7% lower maximal principal stress and 11.5% lower strain than the newborn head. Material properties of the brain had little effects on head acceleration and strain/stress within the skull and suture. Elastic moduli of the skull, suture, dura, and scalp determined using optimization techniques were within reported literature ranges and produced impact response that closely matched those measured in previous cadaver tests. The method developed in this study made it possible to investigate the age effects from geometry changes on pediatric head impact responses. The parametric study demonstrated that it is important to consider the material properties and geometric variations together when estimating pediatric head responses and predicting head injury risks.
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