Mechanical response of infant brain to manually inflicted shaking

Abstract

Shaken baby syndrome (SBS) is a contentious issue on both biomechanical and medical fronts, primarily due to a lack of understanding of the loading-injury relationship of infant shaking and the parameters that are deterministic to its nature. In order to address this lack, a finite element (FE) representation of a three month infant head was developed to apply kinematics derived from physical testing with an anthropomorphic infant surrogate. The FE mesh was derived from a three-dimensional geometric basis, allowing for mesh size grading in regions of high importance, and future patient-specific adaptation. Cerebrospinal fluid (CSF) was represented through static pressure equilibration in combination with a locally based squeezing resistance. The results of the simulation indicate that anteroposterior shaking will lead to specific patterns of brain matter motion, increased likelihood of focal axonal injury at contact locations and deep brain structures, and a capacity for the development of subdural hematomas (SDH) due to rupture of central bridging veins.