Relation between diffuse axonal injury and internal head structures on blunt impact.

Abstract

Diffuse axonal injury (DAI) is a severe head injury, which exhibits symptoms of consciousness disturbance and is thought to occur through rotational angular acceleration. This paper analyzes the occurrence of DAI when direct impacts with translational accelerations are applied to two-dimensional head models. We constructed a human model reproducing the human head structure, as well as modified human models with some internal head structures removed. Blunt direct impacts were applied from a lateral direction to the bottom of the third ventricle, considered to be the center of impact, using an impactor. The analysis was done by comparing the macroscopic manifestation of DAI with the shear stress as the engineering index. In the analytical data obtained from the human model, shear stresses were concentrated on the corpus callosum and the brain stem, in the deep area. This agrees with regions of the DAI indicated by small hemorrhages in the corpus callosum and the brain stem. The analytical data obtained by the modified human models show that the high shear stress on the corpus callosum is influenced by the falx cerebri, while the high shear stress on the brain stem is influenced by the tentorium cerebelli and the shape of the brain. These results indicate that DAI, generally considered to be influenced by angular acceleration, may also occur through direct impact with translational acceleration. We deduced that the injury mechanism of DAI is related to the concentration of shear stress on the core of the brain, since the internal head structures influence the impact stress concentration.