Modeling Neck and Brain Injuries in Infants

Ponce, Ernesto; Ponce, Daniel

doi:10.1109/mcg.2011.99

Cited by 4 publications

(7 citation statements)

References 7 publications

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“…Morison [18] observed brain stresses to increase from brainstem to vertex, with maximum values of 0.8 kPa. Ponce & Ponce [30] found the largest displacements in the central areas of the brain and a more or less uniform distribution of stresses across the brain.…”

Section: Resultsmentioning

confidence: 99%

“…Morison [18] was one of the very few specifically measuring these stretch ratio limits for infants in a small sample of pediatric bridging veins and suggests that tolerance levels for these veins might be lower than values reported for larger and higher age ranges in literature. Threshold values for tissue strains leading to DAI in Couper & Albermani [28] were derived from in vitro animal experiments by Morrison et al [40], while Ponce & Ponce [30] used brain shear stress thresholds that were not measured, but estimated by Meyer et al [41] through numerical reconstruction of real-life cases. In their FEM used to study the likelihood of RH during IHI-ST events, Hans et al [23] used threshold values for the retinal adhesion force from monkey eyes experiments by Kita & Marmor [42, 43].…”

Section: Resultsmentioning

confidence: 99%

“…Stresses build up over multiple shaking cycles. Cheng et al [6]QualitativeSpecial features of infant skulls, such as fontanelle, are fundamentally important to understand how the head behaves when shaken. Couper & Albermani [28]Threshold comparisonShaking an infant leads to a specific pattern of brain motion, increased likelihood of focal axonal injury at deep brain regions and at locations of brain-skull contact, and a capacity for development of SDH due to bridging vein rupture. Batterbee et al [29]QualitativeSensitivity of the model outputs to parameters values depends on the shaking conditions. Particularly, density ratio, CSF thickness and fontanelle size have sensitivity that depends on excitation type because they affect buoyance effects, which are more dominant in translational than in rotational excitation. Ponce & Ponce [30]QualitativeFEM appears to be a practical, universal, economical and fast tool with important forensic use. Coats et al [31]QualitativeIntercranial hemorrhage in piglets is best predicted by a model containing spring connectors to represent pia-arachnoid complex. Top 1% peak connector strains are best predictor of intercranial hemorrhage. Yoshida et al [32]Comparison with impactsThe time integral of stress in the eye model could be a good predictor of RH during IHI-ST.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Modeling of inflicted head injury by shaking trauma in children: what can we learn?

Zandwijk

Vester

Bilo

et al. 2019

Forensic Sci Med Pathol

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Various types of complex biomechanical models have been published in the literature to better understand processes related to inflicted head injury by shaking trauma (IHI-ST) in infants. In this systematic review, a comprehensive overview of these models is provided. A systematic review was performed in MEDLINE and Scopus for articles using physical (e.g. dolls) and mathematical (e.g. computer simulations) biomechanical models for IHI-ST. After deduplication, the studies were independently screened by two researchers using PRISMA methodology and data extracted from the papers is represented in a “7-steps description”, addressing the different processes occurring during IHI-ST. Eleven papers on physical models and 23 papers on mathematical models were included after the selection process. In both categories, some models focus on describing gross head kinematics during IHI-ST events, while others address the behavior of internal head- and eye structures in various levels of detail. In virtually all physical and mathematical models analyzed, injury thresholds are derived from scaled non-infant data. Studies focusing on head kinematics often use injury thresholds derived from impact studies. It remains unclear to what extent these thresholds reflect the failure thresholds of infant biological material. Future research should therefore focus on investigating failure thresholds of infant biological material as well as on possible alternative injury mechanism and alternative injury criteria for IHI-ST. Electronic supplementary material The online version of this article (10.1007/s12024-019-00093-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Modeling of inflicted head injury by shaking trauma in children: what can we learn?

Zandwijk

Vester

Bilo

et al. 2019

Forensic Sci Med Pathol

View full text Add to dashboard Cite

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“…A total of 14 IHI-ST assessment studies [7,8,[14][15][16]23,46,[74][75][76][77][78][79][80] were found. In these studies 25 unique injury thresholds were used for the 35 times that an IHI-ST injury was assessed.…”

Section: Identified Assessment Studiesmentioning

confidence: 99%

“…[108] impact to the head was part of the motion. Morison [109] INT N/A 41 Bridging vein rupture 1.00 0.00 0.00 0.00 1.00 Ponce and Ponce [110] EXT…”

Section: Fundingmentioning

confidence: 99%

Thresholds for the assessment of inflicted head injury by shaking trauma in infants: a systematic review

Schiks

Dankelman

Loeve

2020

Forensic Science International

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In order to investigate potential causal relations between the shaking of infants and injuries, biomechanical studies compare brain and skull dynamic behavior during shaking to injury thresholds. However, performing shaking tolerance research on infants, either in vivo or ex vivo, is extremely difficult, if not impossible. Therefore, infant injury thresholds are usually estimated by scaling or extrapolating adult or animal data obtained from crash tests or whiplash experiments. However, it is doubtful whether such data accurately matches the biomechanics of shaking in an infant. Hence some thresholds may be inappropriate to be used for the assessment of inflicted head injury by shaking trauma in infants. A systematic literature review was conducted to 1) provide an overview of existing thresholds for headand neck injuries related to violent shaking, and 2) to identify and discuss which thresholds have been used or could be used for the assessment of inflicted head injury by shaking trauma in infants. Key findings: The majority of studies establishing or proposing injury thresholds were found to be based on loading cycle durations and loading cycle repetitions that did not resemble those occurring during shaking, or had experimental conditions that were insufficiently documented in order to evaluate the applicability of such thresholds. Injury thresholds that were applied in studies aimed at assessing whether an injury could occur under certain shaking conditions were all based on experiments that did not properly replicate the loading characteristics of shaking. Somewhat validated threshold scaling methods only exist for scaling concussive injury thresholds from adult primate to adult human. Scaling methods that have been used for scaling other injuries, or for scaling adult injury thresholds to infants were not validated. There is a clear and urgent need for new injury thresholds established by accurately replicating the loading characteristics of shaking.

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Finite element models and material data for analysis of infant head impacts

Brooks

Choi

Garnich

et al. 2018

Heliyon

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Finite element (FE) models of the infant human head may be used to discriminate injury patterns resulting from accidents (e.g. falls) and from abusive head trauma (AHT). Existing FE models of infant head impacts are reviewed. Reliability of the material models is the major limitation currently. Infant head tissue properties differ from adults (notably in suture stiffness and strain-to-failure), change with age, and experimental data is scarce. The available data on scalp, cranial bone, dura, and brain are reviewed. Data is most scarce for living brain. All infant head model to date, except one, have used linear elastic models for all tissues except the brain (viscoelastic or Ogden hyperelastic), and do not capture the full complexity of tissue response, but the predicted whole-head response may be of acceptable accuracy. Recent work by Li, Sandler and Kleiven has used hyperelastic models for scalp and dura, and an orthotropic model for bone. There is a need to simulate falls from greater than one metre, and blunt force impacts.

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Modeling Neck and Brain Injuries in Infants

Cited by 4 publications

References 7 publications

Modeling of inflicted head injury by shaking trauma in children: what can we learn?

Modeling of inflicted head injury by shaking trauma in children: what can we learn?

Thresholds for the assessment of inflicted head injury by shaking trauma in infants: a systematic review

Finite element models and material data for analysis of infant head impacts

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