Coup and contre-coup injury:​ observations on the mechanics of visible brain injuries in the rhesus monkey

Ommaya, Ayub K.<sup>1</sup>; Grubb, Jr, Robert L.<sup>1</sup>; Naumann, Ronald A.<sup>1</sup>

Affiliations

¹Branch of Surgical Neurology National Institute of Neurological Diseases and Stroke, National Institutes of Health, Public Health Service, U.S. Department of Health, Education and Welfare, Bethesda, Maryland

Abstract and keywords

The distribution of coup and contre-coup contusions and subdural hematomas after frontal and occipital impacts has been studied in the rhesus monkey. The effect of skull fracture on these lesions is noted, and the data compared to known postmortem observations in man. The translation/cavitation theory for brain injury as presently conceived is not supported by these data. The skull distortion and head rotation hypothesis offers opportunities for developing a better theory for brain injury by direct as well as indirect impact. The significance of these observations for design of protective devices is briefly discussed.

Keywords: brain injuries; contre-coup injury; mechanics; safety standards; accident prevention

Links

DOI: 10.3171/jns.1971.35.5.0503

PubMed: 5000943

WoS: A1971K438000001

History

Received: 1970-08-14

Cited Works (9)

Year	Entry
1970	Hirsch AE, Ommaya AK, Mahone RH. Tolerance of subhuman primate brain to cerebral concussion. In: Gurdjian ES, Lange WA, Patrick LM, Thomas LM, eds. Impact Injury and Crash Protection. Springfield, IL: Charles C. Thomas; 1970:352-369.
1970	Hirsch AE, Ommaya AK. Protection from brain injury: the relative significance of translational and rotational motions of the head after impact. In: Proceedings of the 14th Stapp Car Crash Conference. November 17-18, 1970; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:144-151. SAE 700899.
1943	Holbourn AHS. Mechanics of head injuries. Lancet. October 9, 1943;242(6267):438-441.
1968	Ommaya AK, Faas F, Yarnell P. Whiplash injury and brain damage: an experimental study. JAMA. April 22, 1968;204(4):285-289.
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1945	Holbourn AHS. The mechanics of brain injuries. Br Med Bull. January 1945;3(6):147-149.
1966	Ommaya AK, Hirsch AE, Flamm ES, Mahone RH. Cerebral concussion in the monkey: an experimental model. Science. July 8, 1966;153(3732):211-212.
1966	Gurdjian ES, Roberts VL, Thomas LM. Tolerance curves of acceleration and intracrantal pressure and protective index in experimental head injury. J Trauma. September 1966;6(5):600-604.
1966	Ommaya AK, Hirsch AE, Martinez JL. The role of whiplash in cerebral concussion. In: Proceedings of the 10th Stapp Car Crash Conference. November 8-9, 1966; Hollomon Air Force Base, NM. Warrendale, PA: Society of Automotive Engineers:314-324. SAE 660804.

Cited By (37)

Year	Entry
2002	Ommaya AK, Goldsmith W, Thibault L. Biomechanics and neuropathology of adult and paediatric head injury. Br J Radiol. June 2002;16(3):220-242.
2015	King AI. Introduction to and applications of injury biomechanics. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:1-31.
2015	Melvin JW, Yoganandan N. Biomechanics of brain injury: a historical perspective. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:221-245.
2017	Jones DA, Urban JE, Weaver AA, Stitzel JD. Evaluation of the effects of skull deflection on brain tissue response using finite element simulation. In: Proceedings of the 25th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 5-8, 2017; Detroit, MI.
2012	Fievisohn EM, Vaughn BM, Hardy WN. Short term mild traumatic brain injury mechanisms and pathogenesis studied in a Göttingen minipig model. In: Proceedings of the 40th International Workshop on Human Subjects for Biomechanical Research. 2012.
1973	Ommaya AK, Thibault L. Head and spinal injury tolerance with no direct head impact. In: Proceedings of the 1973 International IRCOBI Conference on the Biomechanics of Impact. June 26-27, 1973; Amsterdam, The Netherlands.311-319.
1975	Stålhammar D, Olsson Y. Experimental brain damage from fluid pressure due to impact acceleration: study of effects of "contre-coup type" pressure changes intracranially in rabbits. In: Proceedings of the 1975 International IRCOBI Conference on the Biomechanics of Impact. September 9-11, 1975; Birmingham, UK.164-176.
1995	Shreiber DI, Gennarelli TA, Meaney DF. The incidence of cerebral contusions in the human: a physical modeling study. In: Proceedings of the 1995 International IRCOBI Conference on the Biomechanics of Impact. September 13-15, 1995; Brunnen, Switzerland.233-244.
1985	Chapon A, Dedoyan AJ, Verriest JP. Clinical study of head injuries in patients with traumatic unconsciousness. In: Proceedings of the 1985 International IRCOBI/AAAM Conference on the Biomechanics of Impact. September 24-26, 1985; Göteborg, Sweden.33-54.
1985	Viano DC. Perspectives on head injury research. In: Proceedings of the 1985 International IRCOBI/AAAM Conference on the Biomechanics of Impact. September 24-26, 1985; Göteborg, Sweden.159-176.
2013	Stuart CA, Cripton PA, Dressler DM, Dennison CR, Richards D. Bicycle helmet efficacy using Hybrid III and magnesium headforms. In: Proceedings of the 9th Ohio State University Injury Biomechanics Symposium. May 19-21, 2013; Columbus, OH.
2016	Jones DA, Urban JE, Weaver AA, Stitzel JD. Investigation of head injury mechanisms through multivariate finite element simulation. In: Proceedings of the 12th Ohio State University Injury Biomechanics Symposium. June 5-7, 2016; Columbus, OH.
2004	Goldsmith W, Plunket J. A biomechanical analysis of the causes of traumatic brain injury in infants and children. Am J Forensic Med Pathol. June 2004;25(2):89-100.
1989	Viano DC, King AI, Melvin JW, Weber K. Injury biomechanics research: an essential element in the prevention of trauma. J Biomech. 1989;22(5):403-417.
1994	Chu C-S, Lin M-S, Huang H-M, Lee M-C. Finite element analysis of cerebral contusion. J Biomech. February 1994;27(2):187-194.
2012	Breedlove EL, Robinson M, Talavage TM, Morigaki KE, Yoruk U, O'Keefe K, King J, Leverenz LJ, Gilger JW, Nauman EA. Biomechanical correlates of symptomatic and asymptomatic neurophysiological impairment in high school football J Biomech. April 30, 2012;45(7):1265-1272.
1999	Huang H-M, Lee M-C, Chiu W-T, Chen C-T, Lee S-Y. Three-dimensional finite element analysis of subdural hematoma. J Trauma. September 1999;47(3):538-544.
2002	Shaw NA. The neurophysiology of concussion. Prog Neurobiol. July 2002;67(4):281-344.
2012	Post A, Hoshizaki TB. Mechanisms of brain impact injuries and their prediction: a review. Trauma. October 2012;14(4):327-349.
2021	Sharkey J. Bridging the Gap in Clinical Translation: Optimising an Ovine Model of Traumatic Brain Injury [PhD thesis]. University of Adelaide; June 2021.
2002	Ivarsson J. Physical Modeling of Brain and Head Kinematics [PhD thesis]. Göteburg, Sweden: Chalmers University of Technology; 2002.
2021	Eckersley C. Cavitation in Blunt Traumatic Brain Injury [PhD thesis]. Duke University; 2021.
2009	Verschueren P. Biomechanical Analysis of Head Injuries Related to Bicycle Accidents and a New Bicycle Helmet Concept [PhD thesis]. Leuven, Belgium: Katholieke Universiteit Leuven; July 2009.
2010	Delye H. Better Bicycle Head Protection by Improving the Knowledge of the Biomechanics of Head Injuries [PhD thesis]. Leuven, Belgium: Katholieke Universiteit Leuven; March 2010.
2008	Fijalkowski RJ. Rotational Acceleration Pulse Characteristics Affect Mild Diffuse Brain Injury Severity [PhD thesis]. Marquette University; May 2008.
2006	Klinich KD. Estimating Infant Head Injury Tolerance and Impact Response [PhD thesis]. University of Michigan; 2006.
2011	Coulson NR. The Influence of Impact Mass, Inbound Velocity and System Compliance on the Dynamic Response of a Hybrid III Head Form [Master's thesis]. Ottawa, ON: University of Ottawa; 2011.
2013	Post A. The Influence of Dynamic Response Characteristics on Traumatic Brain Injury [PhD thesis]. Ottawa, ON: University of Ottawa; 2013.
2016	Kendall M. Comparison and Characterization of Different Concussive Brain Injury Events [PhD thesis]. University of Ottawa; 2016.
1998	Shreiber DI. Experimental and Computational Modeling of Traumatic Brain Injury: In Vivo Thresholds for Mechanical Disruption of the Blood-Brain Barrier [PhD thesis]. Philadelphia, PA: University of Pennsylvania; 1998.
1995	Guskiewicz KM. Effect of Mild Head Injury on Postural Stability [PhD thesis]. Charlottesville, VA: University of Virginia; May 1995.
2019	Alshareef AA. Deformation of the Human Brain Under Rotational Loading [PhD thesis]. Charlottesville, VA: University of Virginia; May 2019.
1994	Ruan JS. Impact Biomechanics of Head Injury by Mathematical Modeling [PhD thesis]. Detroit, MI: Wayne State University; 1994.
2001	Zhang L. Computational Biomechanics of Traumatic Brain Injury: An Investigation of Head Impact Response and American Football Head Injury [PhD thesis]. Detroit, MI: Wayne State University; May 2001.
2007	Hardy WN. Response of the Human Cadaver Head to Impact [PhD thesis]. Detroit, MI: Wayne State University; December 2007.
2018	Arora T. Development of a Subhuman Primate Brain Finite Element Model to Investigate Brain Injury Thresholds Induced by Head Rotation [Master's thesis]. Detroit, MI: Wayne State University; August 2018.
2015	Urban JE. Real-World and Population-Based Studies of Head Injury Causation [PhD thesis]. Winston-Salem, NC: Wake Forest University; May 2015.