Concussion in professional football: brain responses by finite element analysis: part 9

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Viano, David C.¹; Casson, Ira R.²; Pellman, Elliot J.³; Zhang, Liying⁴; King, Albert I.⁴; Yang, King H.⁴

Concussion in professional football: brain responses by finite element analysis: part 9

Neurosurgery. November 2005;57(5):891-916

Affiliations

¹ProBiomechanics, LLC, Bloomfield Hills, Michigan, Bioengineering Center, Wayne State University, Detroit, Michigan

²Department of Neurology, Long Island Jewish Medical Center, New Hyde Park, New York, and Department of Neurology, Albert Einstein College of Medicine, Bronx, New York

³ProHEALTH Care Associates, LLP Lake Success, New York

⁴Bioengineering Center, Wayne State University, Detroit, Michigan
Abstract and keywords

Objective: Brain responses from concussive impacts in National Football League football games were simulated by finite element analysis using a detailed anatomic model of the brain and head accelerations from laboratory reconstructions of game impacts. This study compares brain responses with physician determined signs and symptoms of concussion to investigate tissue-level injury mechanisms.

Methods: The Wayne State University Head Injury Model (Version 2001) was used because it has fine anatomic detail of the cranium and brain with more than 300,000 elements. It has 15 different material properties for brain and surrounding tissues. The model includes viscoelastic gray and white brain matter, membranes, ventricles, cranium and facial bones, soft tissues, and slip interface conditions between the brain and dura. The cranium of the finite element model was loaded by translational and rotational accelerations measured in Hybrid III dummies from 28 laboratory reconstructions of NFL impacts involving 22 concussions. Brain responses were determined using a nonlinear, finite element code to simulate the large deformation response of white and gray matter. Strain responses occurring early (during impact) and mid-late (after impact) were compared with the signs and symptoms of concussion.

Results: Strain concentration “hot spots” migrate through the brain with time. In 9 of 22 concussions, the early strain “hot spots” occur in the temporal lobe adjacent to the impact and migrate to the far temporal lobe after head acceleration. In all cases, the largest strains occur later in the fornix, midbrain, and corpus callosum. They significantly correlated with removal from play, cognitive and memory problems, and loss of consciousness. Dizziness correlated with early strain in the orbital-frontal cortex and temporal lobe. The strain migration helps explain coup-contrecoup injuries.

Conclusion: Finite element modeling showed the largest brain deformations occurred after the primary head acceleration. Midbrain strain correlated with memory and cognitive problems and removal from play after concussion. Concussion injuries happen during the rapid displacement and rotation of the cranium, after peak head acceleration and momentum transfer in helmet impacts.

Keywords: Concussion; Finite element modeling; Football helmets; Head injury; Injury mechanisms; Sport injury
Links

DOI: 10.1227/01.NEU.0000186950.54075.3B

PubMed: 16284560

WoS: 000233173400020
History

Received: 2005-03-03

Accepted: 2005-09-08

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2007	Maikos J. In Vivo Tissue-Level Thresholds for Spinal Cord Injury [PhD thesis]. Rutgers University; October 2007.
2019	Jannesar S. The Mechanics of Contusion Spinal Cord Injury: Towards Patient-Specific Assessments of Mechanical Loading and Injury [PhD thesis]. Simon Fraser University; Summer 2019.
2012	Russell CM. A Nonlinear Finite Element Model of the Rat Cervical Spine: Validation and Correlation With Histological Measures of Spinal Cord Injury [Master's thesis]. Vancouver, BC: University of British Columbia; August 2012.
2020	Pryhoda MK. A Longitudinal Examination of Biomechanical Balance and Quantitative Multidomain Assessments During Recovery Following Sport-Related Concussion [PhD thesis]. University of Colorado Denver; June 2020.
2014	Patton DA. The Biomechanical Determinants of Sports-Related Concussion: Finite Element Simulations of Unhelmeted Head Impacts to Evaluate Kinematic and Tissue-Level Predictors of Injury and Investigate the Design Implications for Soft-Shell Headgear [PhD thesis]. University of New South Wales; March 2014.
2012	Oeur A. An Analysis of Head Impact Angle on the Dynamic Response of a Hybrid III Headform and Brain Tissue Deformation [Master's thesis]. Ottawa, ON: University of Ottawa; December 2012.
2014	Rousseau P. Analysis of Concussion Metrics of Real-World Concussive and Non-Injurious Elbow and Shoulder to Head Collisions in Ice Hockey [PhD thesis]. Ottawa, ON: University of Ottawa; 2014.
2016	Kendall M. Comparison and Characterization of Different Concussive Brain Injury Events [PhD thesis]. University of Ottawa; 2016.
2018	Oeur RA. The Effects of Reconstructed Head Impact Event Parameters on Risk of Sport Related Concussions [PhD thesis]. Ottawa, ON: University of Ottawa; 2018.
2019	Cournoyer J. Head Impact Severity Associated With Loss of Consciousness and Impact Seizures in Sport-Related Concussions [PhD thesis]. Ottawa, ON: University of Ottawa; 2019.
2014	Chen Y. Astrocyte Signaling in Traumatic Brain Injury [PhD thesis]. Philadelphia, PA: University of Pennsylvania; 2014.
2017	Sanchez EJ. Evaluation of the Efficacy of Head and Brain Injury Risk Functions [Master's thesis]. Charlottesville, VA: University of Virginia; December 2017.
2019	Wu T. Integration of Interspecies Data for Developing Tissue-Level Brain Injury Risk Functions [PhD thesis]. Charlottesville, VA: University of Virginia; May 2019.
2020	Giudice JS. Personalized Finite Element Modeling of the Brain: Understanding Subject-Specific Deformation Patterns [PhD thesis]. Charlottesville, VA: University of Virginia; December 2020.
2019	Bruneau D. Investigation of Head and Brain Response in Football Helmet Impacts Using a Finite Element Model of the Head and Neck With Active Muscle [Master's thesis]. University of Waterloo; 2019.
2022	Pastula CC. Assessment of Occupant Response in Frontal Bus Crash Scenarios Using Human Body Models to Improve Public Transportation Safety [Master's thesis]. University of Waterloo; 2022.
2009	Jin X. Biomechanical Response and Constitutive Modeling of Bovine Pia-Arachnoid Complex [PhD thesis]. Detroit, MI: Wayne State University; December 2009.
2009	Mao H. Computational Analysis of in Vivo Brain Trauma [PhD thesis]. Detroit, MI: Wayne State University; August 2009.
2011	Sharma S. Biomechanical Analysis of Blast Induced Traumatic Brain Injury: A Finite Element Modeling and Validation Study of Blast Effects on Human Brain [Master's thesis]. Detroit, MI: Wayne State University; August 2011.
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.
2023	Lyu D. Investigation of Biomechanical Thresholds of Mild to Severe Brain Injury Using an Anisotropic Visco-Hyperelastic Finite Element Head Model: Model Development and Simulation of Impact Injury and Blast Injury [PhD thesis]. Detroit, MI: Wayne State University; August 2023.
2016	Brooks JS. The Use of P3b as an Indicator of Neurophysiologic Change from Subconcussive Impacts in Football Players [Master's thesis]. University of Western Ontario; 2016.
2019	Bian K. Predicting and Preventing Traumatic Brain Injury: A Novel Computational Approach [Master's thesis]. London, ON: Western University; August 2019.
2021	Islam SU. Significance of the Neck in Concussive Head Impacts: A Computational Approach [Master's thesis]. University of Western Ontario; 2021.
2020	Decker WB. Utilizing Simplified Human Body and Countermeasure Models for Head Injury Prevention in Contact and Motor Sports [PhD thesis]. Winston-Salem, NC: Wake Forest University; September 2020.