APA 4118 Biomechanics of brain injury

What is the primary goal of the Neurotrauma Impact Science Laboratory at uOttawa?

To decrease all types of head injury in sport.

What are the two main mechanisms of brain injury in sports?

1. An external element imparting energy to the head. 2. The head/brain impacting something that decelerates it.

What type of injuries are more common in helmeted sports like ice hockey?

Subdural hematoma and concussion.

What percentage of emergency department visits for sport-related brain injuries were concussion-related in 2014-2015?

94%.

What is a common cause of diffuse axonal injury (DAI)?

Rapid rotational accelerations.

What is the relationship between game environment and head injury risk?

Game rules can influence the risk of head injuries in sport.

What are the dependent variables used in neurotrauma research?

Linear acceleration, rotational acceleration, maximum principal strain, Von Mises stress, strain rate.

What type of brain injury is characterized by extensive localized axonal and microvascular damage?

Diffuse axonal injury (DAI).

What is the mission of the Neurotrauma Impact Science Laboratory?

To undertake research that contributes to decreasing head injuries in sport.

Which age group saw a 78% increase in emergency department visits for sport-related brain injuries?

0- to 9-year-olds.

What types of traumatic brain injuries are caused by linear acceleration?

Skull fractures and contusions.

What is the significance of the 62% statistic regarding emergency department visits for sport-related brain injuries?

It indicates that 62% of visits were made by males.

What is the role of product certification methods in sports safety?

To evaluate helmets and improve safety standards.

What is the vision of the Neurotrauma Impact Science Laboratory?

To make head injuries a rare and inconsequential part of athletic and leisure activities.

What are the common sports associated with the largest number of brain injury patients in the ED?

Hockey, cycling, and football/rugby.

What are intercranial bleeds and how are they produced?

They are caused by violent shaking and often result from the rupture of bridging veins.

What is the impact of head trauma on brain injury?

Head trauma can lead to injurious damage to vasculature or brain tissues.

What is the purpose of technology development in neurotrauma research?

To create automated data capture for better analysis of head injuries.

What type of hematoma is frequently produced by the rupture of bridging veins?

Cerebral hematoma.

What is the increase in emergency department visits among 10- to 17-year-olds for sport-related brain injuries?

45% increase.

What is a concussive injury?

An injury characterized by transient symptoms that resolve within three days to four weeks.

What are the potential outcomes of a persistent concussive injury?

It may result in serious and permanent disability.

List common symptoms of a concussion.

Headache, loss of consciousness, amnesia, dizziness, confusion, depression, and loss of cognitive facilities.

What percentage of concussive injuries are not reported?

Over 50%.

What causes a concussion?

Rotational motions that cause shear strains damaging brain tissues due to impact.

What is the hallmark characteristic of traumatic brain injury (TBI) of all severities?

Prolonged glucose metabolic depression following an immediate increase in cerebral metabolic rates of glucose.

What is Chronic Traumatic Encephalopathy (CTE)?

A progressive tauopathy resulting from repetitive concussive and/or subconcussive blows to the head.

How long after exposure can CTE develop?

Years or perhaps decades.

What percentage of boxers are estimated to exhibit CTE?

17 - 30%.

What neurological signs and symptoms are associated with CTE?

Dementia, emotional instability, forgetfulness, confusion, decreased cognitive function, headaches, and personality changes.

What are sub-clinical brain injuries?

High frequency, asymptomatic head impacts.

What factors predispose individuals to brain injuries?

Psychological, anatomical, and injury history.

What types of injury events can lead to brain injuries?

Falls, collisions, projectiles, and punches.

What are the key responses of the brain tissue to injury?

Stress, strain, and strain rate.

What factors are involved in measuring brain trauma magnitude?

Mass, compliance, velocity, location, and direction.

What is the impact severity in relation to brain injuries?

It refers to the magnitude of strain experienced by brain tissue during an injury event.

What is the relationship between rotational acceleration and concussion?

Concussion results from rotational motions that cause shear strains damaging brain tissues.

What is the role of glucose metabolism in concussion?

An immediate increase is followed by prolonged metabolic depression, indicating brain injury.

What is dementia pugilistica?

A condition resulting from repeated head trauma, often seen in boxers, leading to cognitive decline.

How does chronic neurocognitive impairment manifest?

As serious and long-term disabilities, including cognitive decline and depression.

What is the significance of measuring brain injury magnitude?

It helps in assessing the severity and potential long-term effects of brain injuries.

What is the purpose of the injury report form at the University of Ottawa Neurotrauma Impact Science Lab?

To describe the impact of injuries using parameters such as velocity, mass, compliance, and location.

What patient information is collected in the injury report?

Age, gender, weight, height, ethnicity, previous head injury, and pre-existing medical conditions.

What parameters are used to describe the collision in the injury report?

Object weight, speed, material, and mode of collision (e.g., walk, run, bike, etc.).

What types of surfaces are listed for impact in the injury report?

Sand, grass, gravel, concrete, ice, steel, and other surfaces.

What is the Glasgow Coma Scale used for in the injury report?

To assess the patient's level of consciousness through eye, verbal, and motor responses.

What types of traumatic injuries are associated with head impacts?

Skull fractures, intracranial bleeds, subdural bleeds, concussions, and diffuse axonal injury.

What does Newton's Second Law of Motion state in the context of head impacts?

F = m x a, meaning the force applied causes the head to accelerate linearly.

How is translational kinetic energy defined in the context of head impacts?

KE = ½mv², where m is mass and v is velocity.

What is the significance of the MADYMO computer simulations in the injury report?

To analyze event dynamics and reconstruct head impact scenarios.

What types of supporting documents can be attached to the injury report?

Injury pictures, incident videos, MRI, CT scans, and DTI.

What is the role of video analysis software in the context of head impacts?

To measure velocity during collision events.

What does the term 'visco-elastic properties' refer to in head injury analysis?

It refers to the properties of brain tissue that affect strain and stress during impacts.

What is the primary impact location indicated in the injury report?

Left or right side of the head.

What types of head protection are tested according to the physics of motion?

Crash helmets that measure energy transfer to the brain during impacts.

What does the term 'linear acceleration' refer to in head impact analysis?

The rate of change of velocity over time when a force is applied to the head.

What is the significance of identifying the location and type of brain tissue strain?

It helps in understanding the effects of different types of head impacts.

What are the symptoms of confusion related to head injuries?

Duration of confusion is recorded in the injury report.

What information is required regarding the helmet in the injury report?

Make, model, size, and availability for analysis.

What is the importance of documenting the physician and hospital in the injury report?

To provide a record of medical evaluation and treatment for the injury.

What are the classifications of collision speed in the injury report?

Slow, moderate, and fast.

What types of falls are documented in the injury report?

Falls from a specified drop height with initial contact noted.

What are concussions diagnosed using?

Symptoms

What defines persistent concussions?

Concussions lasting longer than a month

What types of sports are associated with concussions?

American football, Ice hockey, Lacrosse, Baseball

What is the primary purpose of crash helmets?

To absorb single impacts that occur at high velocities

What standards govern the performance of crash helmets?

DOT, CEN, ASTM, CPSC, FIS, SNELL

What protocols are used to test multi-impact helmets?

NOCSAE, CSA

What is the significance of rotational acceleration in helmet testing?

Some helmets are adopting rotational acceleration pass/fail criteria

What does the equation T=Iα represent?

The relationship between torque (T), moment of inertia (I), and angular acceleration (α)

How is rotational kinetic energy defined?

RKE = ½Iω²

What is the effect of oblique impacts on helmet design?

They reduce peak rotational energy incurred by the helmet wearer

What types of injuries can result from severe traumatic impacts?

Skull fractures (linear), Intracranial bleeds (linear), Subdural bleeds (rotational), Diffuse axonal injury (rotational)

What characterizes acute-concussive injuries?

Transient symptoms that typically resolve in the first three days

What can persistent concussions lead to?

Serious and permanent disability

What are chronic cumulative injuries associated with?

Repetitive trauma leading to long-term disability and neurological disorders (e.g., CTE)

What can impact sensors provide?

Impact frequency count/trauma load and alarms for high energy dangerous hits

What are the limitations of impact sensors?

They cannot diagnose a concussion, have data accuracy issues, high costs, and require participant adherence

What is the role of helmet safety standards?

To drive helmet design and manufacturing

What is the 'de-coupling' effect in helmet technology?

Elastic bladders and helmet shell shift independently to manage rotational and linear energy

What is the impact of torque on the head?

It causes rotational or angular acceleration

What is the significance of managing rotational energy in helmets?

To reduce the risk of rotational injuries during impacts

What is the relationship between frequency and cumulative injury?

Higher frequency of impacts can lead to greater cumulative injuries