The relation between mechanical impact parameters and most frequent bicycle related head injuries.

The most frequent head injuries resulting from bicycle accidents include skull fracture acute subdural hematoma (ASDH), cerebral contusions, and diffuse axonal injury (DAI). This review includes epidemiological studies, cadaver experiments, in vivo imaging, image processing techniques, and computer reconstructions of cycling accidents used to estimate the mechanical parameters leading to specific head injuries. The results of the head impact tests suggest the existence of an energy failure level for the skull fracture, specific for different impact regions (22-24J for the frontal site and 5-15J for temporal site). Typical linear patterns were described for frontal, parietal and occipital skull fracture. Temporal skull fracture described considerably higher variability. In term of contusion mechanogenesis, the experiments proved that relative brain-skull motion will not be prevented if the maximum frequency of the impact frequency spectrum stays below 150Hz or below the frequency corresponding to the impedance peak of the head under investigation. The brain shift patterns in humans, both in dynamic and quasistatic situations were shown to be very complex, with maximum amplitudes localized at the level of the inferolateral aspects of the frontal and temporal lobes. The resulting brain maximum amplitudes differed when the head was subjected to a sagittal or lateral motion. Finally, the presented data support the existence of a critical elongation/stretch criterion for the occurrence of ASDH due to BV rupture, located around 5mm elongation or 25% stretch limit. In addition, a tolerance level lying around 10,000rad/s(2) for pulse durations below 10ms was established for BV rupture, which seems to decrease with increasing pulse duration. The described research indicates that injury specific tolerance criteria can provide a more accurate prediction for head injuries than the currently used HIC. Internal brain lesions are strongly related to rotational effects which are not appropriately accounted by the commonly accepted head injury criterion (HIC). The research summarized in this paper adds significantly to the creation of a fundamental knowledge for the improvement of bicycle helmets as well as other head protective measures. The described investigations and experimental results are of crucial importance also for forensic research.

Rapid prototyping compliant arterial phantoms for in-vitro studies and device testing.

BACKGROUND: Compliant vascular phantoms are desirable for in-vitro patient-specific experiments and device testing. TangoPlus FullCure 930 is a commercially available rubber-like material that can be used for PolyJet rapid prototyping. This work aims to gather preliminary data on the distensibility of this material, in order to assess the feasibility of its use in the context of experimental cardiovascular modelling. METHODS: The descending aorta anatomy of a volunteer was modelled in 3D from cardiovascular magnetic resonance (CMR) images and rapid prototyped using TangoPlus. The model was printed with a range of increasing wall thicknesses (0.6, 0.7, 0.8, 1.0 and 1.5 mm), keeping the lumen of the vessel constant. Models were also printed in both vertical and horizontal orientations, thus resulting in a total of ten specimens. Compliance tests were performed by monitoring pressure variations while gradually increasing and decreasing internal volume. Knowledge of distensibility was thus derived and then implemented with CMR data to test two applications. Firstly, a patient-specific compliant model of hypoplastic aorta suitable for connection in a mock circulatory loop for in-vitro tests was manufactured. Secondly, the right ventricular outflow tract (RVOT) of a patient necessitating pulmonary valve replacement was printed in order to physically test device insertion and assess patient's suitability for percutaneous pulmonary valve intervention. RESULTS: The distensibility of the material was identified in a range from 6.5 × 10(-3) mmHg(-1) for the 0.6 mm case, to 3.0 × 10(-3) mmHg(-1) for the 1.5 mm case. The models printed in the vertical orientation were always more compliant than their horizontal counterpart. Rapid prototyping of a compliant hypoplastic aorta and of a RVOT anatomical model were both feasible. Device insertion in the RVOT model was successful. CONCLUSION: Values of distensibility, compared with literature data, show that TangoPlus is suitable for manufacturing arterial phantoms, with the added benefit of being compatible with PolyJet printing, thus guaranteeing representative anatomical finishing, and quick and inexpensive fabrication. The appealing possibility of printing models of non-uniform wall thickness, resembling more closely certain physiological scenarios, can also be explored. However, this material appears to be too stiff for modelling the more compliant systemic venous system.

The mechanical properties of cranial bone: the effect of loading rate and cranial sampling position.

Linear and depressed skull fractures are frequent mechanisms of head injury and are often associated with traumatic brain injury. Accurate knowledge of the fracture of cranial bone can provide insight into the prevention of skull fracture injuries and help aid the design of energy absorbing head protection systems and safety helmets. Cranial bone is a complex material comprising of a three-layered structure: external layers consist of compact, high-density cortical bone and the central layer consists of a low-density, irregularly porous bone structure. In this study, cranial bone specimens were extracted from 8 fresh-frozen cadavers (F=4, M=4; 81+/-11 years old). 63 specimens were obtained from the parietal and frontal cranial bones. Prior to testing, all specimens were scanned using a microCT scanner at a resolution of 56.9 microm. The specimens were tested in a three-point bend set-up at different dynamic speeds (0.5, 1 and 2.5 m/s). The associated mechanical properties that were calculated for each specimen include the 2nd moment of inertia, the sectional elastic modulus, the maximum force at failure, the energy absorbed until failure and the maximum bending stress. Additionally, the morphological parameters of each specimen and their correlation with the resulting mechanical parameters were examined. It was found that testing speed, strain rate, cranial sampling position and intercranial variation all have a significant effect on some or all of the computed mechanical parameters. A modest correlation was also found between percent bone volume and both the elastic modulus and the maximum bending stress.

Biomechanics of frontal skull fracture.

The purpose of the present study was to investigate whether an energy failure level applies to the skull fracture mechanics in unembalmed post-mortem human heads under dynamic frontal loading conditions. A double-pendulum model was used to conduct frontal impact tests on specimens from 18 unembalmed post-mortem human subjects. The specimens were isolated at the occipital condyle level, and pre-test computed tomography images were obtained. The specimens were rigidly attached to an aluminum pendulum in an upside down position and obtained a single degree of freedom, allowing motion in the plane of impact. A steel pendulum delivered the impact and was fitted with a flat-surfaced, cylindrical aluminum impactor, which distributed the load to a force sensor. The relative displacement between the two pendulums was used as a measure for the deformation of the specimen in the plane of impact. Three impact velocity conditions were created: low (3.60+/-0.23 m/sec), intermediate (5.21+/-0.04 m/sec), and high (6.95+/-0.04 m/sec) velocity. Computed tomography and dissection techniques were used to detect pathology. If no fracture was detected, repeated tests on the same specimen were performed with higher impact energy until fracture occurred. Peak force, displacement and energy variables were used to describe the biomechanics. Our data suggests the existence of an energy failure level in the range of 22-24 J for dynamic frontal loading of an intact unembalmed head, allowed to move with one degree of freedom. Further experiments, however, are necessary to confirm that this is a definitive energy criterion for skull fracture following impact.

Biomechanical properties of the superior sagittal sinus-bridging vein complex.

Finite element models (FEM) of the head are frequently used to simulate traumatic brain injury, leading to a better understanding of brain injury tolerance. The strength of a FEM of the head is dependent on the use of correct material characteristics, experimentally derived for each intracranial tissue, including parasagittal bridging veins (BV). These veins are prone to rupture in their subdural portion upon head impact, giving rise to an acute subdural hematoma (ASDH). The junction of these veins to the superior sagittal sinus (SSS) has been described as an area with distinct vein wall architecture. To understand the biomechanical characteristics of acute subdural hematoma, we studied the SSS-BV complex by loading it to failure in a tensile test. 37 BVs from 9 fresh cadavers were dissected, leaving small strips of SSS attached to the veins. The units were clamped on the SSS and the cortical end of the BV. Strain rates ranged from 0.1-3.8 s(-1). From force-time and strain-time histories, we calculated ultimate strain (epsilon(U)), ultimate stress (sigma(U)), yield strain (epsilon(Y)), yield stress(sigma(Y)) and Young's modulus (E). A mixed-model multivariate analysis of variance (MANOVA) was used to study correlations and strain rate sensitivity of these parameters. We found no strain rate sensitivity. The biomechanical response of the SSS-BV unit in this study was found to be stiffer than reported biomechanical behavior of bridging veins. We conclude that the SSS-BV junction plays an important role in bridging vein rupture, and warrants further investigation to provide FEM with correct material properties for bridging veins.