Abstract
Blast-induced traumatic brain injury (TBI) has become a signature wound of recent military activities and is the leading cause of death and long-term disability among U.S. soldiers. The current limited understanding of brain injury mechanisms impedes the development of protection, diagnostic, and treatment strategies. We believe mathematical models of blast wave brain injury biomechanics and neurobiology, complemented with in vitro and in vivo experimental studies, will enable a better understanding of injury mechanisms and accelerate the development of both protective and treatment strategies. The goal of this paper is to review the current state of the art in mathematical and computational modeling of blast-induced TBI, identify research gaps, and recommend future developments. A brief overview of blast wave physics, injury biomechanics, and the neurobiology of brain injury is used as a foundation for a more detailed discussion of multiscale mathematical models of primary biomechanics and secondary injury and repair mechanisms. The paper also presents a discussion of model development strategies, experimental approaches to generate benchmark data for model validation, and potential applications of the model for prevention and protection against blast wave TBI.
Highlights
In the current conflicts in Iraq and Afghanistan improvised explosive devices (IEDs) are frequently used weapons of adversary combatants and terrorists against U.S troops and civilians (Ramasamy et al, 2009; Duckworth et al, 2012; Kang et al, 2012)
Most mild TBI (mTBI) cases result in cognitive deficits immediately after the brain injury and only ∼5% report brief loss of consciousness (Hoge et al, 2008; Ling et al, 2009)
Validated biomechanics and physiology based mathematical modeling tools of blast head injury may reduce the need for trial-and-error tests involving laboratory animals, yet provide a capability to study brain injury mechanisms, perhaps accelerating the development of neuroprotective strategies and aiding in the development of improved protective armor (Leggieri, 2009; Gupta and Przekwas, 2011)
Summary
In the current conflicts in Iraq and Afghanistan improvised explosive devices (IEDs) are frequently used weapons of adversary combatants and terrorists against U.S troops and civilians (Ramasamy et al, 2009; Duckworth et al, 2012; Kang et al, 2012). Military helmets are traditionally designed to protect against ballistic and impact injury and even recent redesign of the sling suspension replaced by foam pads did not completely resolve blast TBI issues. Given these uncertainties and the continued need to protect U.S military, the DoD has made substantial research investments in understanding military relevant acute TBI and chronic mTBI (Leggieri, 2009). The majority of these efforts use an experimental approach of animal testing, in vitro study, and analysis of clinical data, all of which are useful and necessary but are slow, expensive, lack injury scaling, and prediction capability
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