Biomechanical analysis of skull trauma and opportunity in neuroradiology interpretation to explain the post-concussion syndrome: literature review and case studies presentation

Abstract

Traumatic head injuries are one of the leading causes of emergency worldwide due to their frequency and associated morbidity. The circumstances of their onset are often sports activities or road accidents. Numerous studies analysed post-concussion syndrome from a psychiatric and metabolic point of view after a mild head trauma. The aim was to help understand how the skull can suffer a mechanical deformation during a mild cranial trauma, and if it can explain the occurrence of some post-concussion symptoms. A multi-step electronic search was performed, using the following keywords: biomechanics properties of the skull, three-dimensional computed tomography of head injuries, statistics on skull injuries, and normative studies of the skull base. We analysed studies related to the observation of the skull after mild head trauma. The analysis of 23 studies showed that the cranial sutures could be deformed even during a mild head trauma. The skull base is a major site of bone shuffle. Three-dimensional computed tomography can help to understand some post-concussion symptoms. Four case studies showed stenosis of jugular foramen and petrous bone asymmetries who can correlate with concussion symptomatology. In conclusion, the skull is a heterogeneous structure that can be deformed even during a mild head trauma.

Symmetry of the Human Head—Are Symmetrical Models More Applicable in Numerical Analysis?

“…In the Greek population examined by Chovalopaulou et al, the highest FA was found in the skull-base region [9]. The clinical importance of asymmetry of jugular foramen was suggested by Distriquin et al in their paper in which they indicated a direct relation between the posttraumatic asymmetry of skull-base foramina and symptoms of the post-concussion syndrome [13].…”

Cranial Bone Changes Induced by Mild Traumatic Brain Injuries: A Neglected Player in Concussion Outcomes?

“… 55 , 56 A recent systematic review of clinical evidence concluded that the cranium can be deformed even by an mTBI. 57 Further, several case studies suggest that damage proximal to the cranial base in particular can contribute to neurovascular dysfunction, which may underlie some of the acute symptoms associated with concussion, such as dizziness and headache. 57 …”