Severe-to-fatal head injuries in motor vehicle impacts

Yoganandan, Narayan; Baisden, Jamie; Maiman, Dennis J.; Gennarelli, Thomas A.; Guan, Yabo; Pintar, Frank A.; Laud, Prakash; Ridella, Stephen A.

doi:10.1016/j.aap.2010.02.017

Cited by 34 publications

(15 citation statements)

References 22 publications

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“…There were no statistically significant correlations between IPC and other variables, which may because of the small sample size. These two parameters have been previously identified as reliable predictors of MVC occupant injury severity in individuals with head trauma 5,[25][26][27] and without head trauma. 28 Many of the previous studies have investigated only injury incidence and mortality, with only a few exploring how specific occupant parameters affect MVC-associated brain injury.…”

Section: Discussionmentioning

confidence: 99%

“…1 Many studies have been conducted to investigate the epidemiology of TBI using databases such as the Crash Injury Research and Engineering Network (CIREN) and the National Automotive Sampling System (NASS) database. [2][3][4][5][6] The CIREN database contains detailed vehicle, crash, and medical data on injured MVC vehicle occupants. 7 It contains pre-crash information, along with detailed scene and vehicle investigation, medical images, and injury causation scenario and patient outcome.…”

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confidence: 99%

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Motor Vehicle Crash-Related Subdural Hematoma from Real-World Head Impact Data

Urban

Whitlow

Edgerton

et al. 2012

Journal of Neurotrauma

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Approximately 1,700,000 people sustain a traumatic brain injury (TBI) each year and motor vehicle crashes (MVCs) are a leading cause of hospitalization from TBI. Acute subdural hematoma (SDH) is a common intracranial injury that occurs in MVCs associated with high mortality and morbidity rates. In this study, SDH volume and midline shift have been analyzed in order to better understand occupant injury by correlating them to crash and occupant parameters. Fifty-seven head computed tomography (CT) scans were selected from the Crash Injury Research Engineering Network (CIREN) with Abbreviated Injury Scale (AIS) level 3 + SDH. Semi-automated methods were used to isolate the intracranial volume. SDH and additional occupant intracranial injuries were segmented across axial CT images, providing a total SDH injury volume. SDH volume was correlated to crash parameters and occupant characteristics. Results show a positive correlation between SDH volume and crash severity in near-side and frontal crashes. Additionally, the location of the resulting hemorrhage varied by crash type. Those with greater SDH volumes had significantly lower Glasgow Coma Scale (GCS) scores at the crash site in near-side crashes. Age and fracture type were found to be significant contributors to SDH volume. This study is a volumetric analysis of real world brain injuries and known MVC impacts. The results of this study demonstrate a relationship among SDH volume, crash mechanics, and occupant characteristics that provide a better understanding of the injury mechanisms of MVC-associated TBI.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Motor Vehicle Crash-Related Subdural Hematoma from Real-World Head Impact Data

Urban

Whitlow

Edgerton

et al. 2012

Journal of Neurotrauma

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“…Coincidentally, TBIs caused by MVAs may also differ from other causes because of the greater biomechanical forces associated with high-speed acceleration and deceleration injuries, [42][43][44] differences that may not be captured by our relatively course-grained measures of injury severity (Glasgow Coma Scale [GCS], loss of consciousness [LOC], post-traumatic amnesia [PTA]), but may be reflected in poorer outcomes (e.g., PCS). MVAs may also involve some degree of psychological trauma, which may additionally affect outcome.…”

Section: Introductionmentioning

confidence: 99%

Contribution of Psychological Trauma to Outcomes after Traumatic Brain Injury: Assaults versus Sporting Injuries

Mathias

Harman-Smith

Bowden

et al. 2014

Journal of Neurotrauma

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Clinical research into outcomes after traumatic brain injury (TBI) frequently combines injuries that have been sustained through different causes (e.g., car accidents, assaults, and falls), the effect of which is not well understood. This study examined the contribution of injury-related psychological trauma—which is more commonly associated with specific types of injuries—to outcomes after nonpenetrating TBI in order to determine whether it may be having a differential effect in samples containing mixed injuries. Data from three groups that were prospectively recruited for two larger studies were compared: one that sustained a TBI as a result of physical assaults (i.e., psychologically traumatizing) and another as a result of sporting injuries (i.e., nonpsychologically traumatizing), as well as an orthopedic control group (OC). Psychosocial and emotional (postconcussion symptoms, injury-related stress, and depression), cognitive (memory, abstract reasoning, problem solving, and verbal fluency), and functional (general outcome; resumption of home, social, and work roles) outcomes were all assessed. The TBI(assault) group reported significantly poorer psychosocial and emotional outcomes and higher rates of litigation (criminal rather than civil) than both the TBI(sport) and OC groups approximately 6 months postinjury, but there were no differences in the cognitive or functional outcomes of the three groups. The findings suggest that the cause of a TBI may assist in explaining some of the differences in outcomes of people who have seemingly comparable injuries. Involvement in litigation and the cause of an injury may also be confounded, which may lead to the erroneous conclusion that litigants have poorer outcomes.

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“…[4] In the literature, risk factors for and causes of temporal bone fractures are: younger age, male gender and motor vehicle accidents. [5][6][7][8] Similarly, in our series, traffic accidents were the primary mechanism of the injury, with a 54.5% ratio; 76.6% of the cases were male and the mean age was 34.1 years.…”

Section: Discussionmentioning

confidence: 99%