References

2017

Taylor, Mary Ellen; Sanner, Jennifer E

The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms Journal Article

In: Journal of School Nursing, vol. 33, no. 1, pp. 73–81, 2017, ISBN: 1059-8405.

Abstract | Links | BibTeX | Tags: Athletes, Athletic Injuries, brain, brain concussion, Intention, knowledge, Schools, Sports, Students

2016

Johnson, K L; Chowdhury, S; Lawrimore, W B; Mao, Y; Mehmani, A; Prabhu, R; Rush, G A; Horstemeyer, M F

Constrained topological optimization of a football helmet facemask based on brain response Journal Article

In: Materials and Design, vol. 111, pp. 108–118, 2016.

Abstract | Links | BibTeX | Tags: Accident prevention, ALGORITHMS, brain, Concussion, Constrained optimization, Design, Design optimization, finite element analysis, Finite element method, football helmet, Fuel additives, Genetic algorithms, Multiobjective optimization, Optimization, Safety devices, Shear strain, Sports, Surrogate model, Surrogate modeling, Topology, Traumatic Brain Injuries, traumatic brain injury

@article{Johnson2016a,

title = {Constrained topological optimization of a football helmet facemask based on brain response},

author = {Johnson, K L and Chowdhury, S and Lawrimore, W B and Mao, Y and Mehmani, A and Prabhu, R and Rush, G A and Horstemeyer, M F},

doi = {10.1016/j.matdes.2016.08.064},

year  = {2016},

date = {2016-01-01},

journal = {Materials and Design},

volume = {111},

pages = {108--118},

abstract = {Surrogate model-based multi-objective design optimization was performed to reduce concussion risk during frontal football helmet impacts. In particular, a topological decomposition of the football helmet facemask was performed to formulate the design problem, and brain injury metrics were exploited as objective functions. A validated finite element model of a helmeted human head was used to recreate facemask impacts. Due to the prohibitive computational expense of the full scale simulations, a surrogate modeling approach was employed. An optimal surrogate model selection framework, called Concurrent Surrogate Model Selection, or COSMOS, was utilized to identify the surrogate models best suited to approximate each objective function. The resulting surrogate models were implemented in the Non-dominated Sorting Genetic Algorithm II (NSGA-II) optimization algorithm. Constraints were implemented to control the solid material fraction in the facemask design space, and binary variables were used to control the placement of the facemask bars. The optimized facemask designs reduced the maximum tensile pressure in the brain by 7.5% and the maximum shear strain by a remarkable 39.5%. This research represents a first-of-its-kind approach to multi-objective design optimization on a football helmet, and demonstrates the possibilities that are achievable in improving human safety by using such a simulation-based design optimization. © 2016 Elsevier Ltd},

keywords = {Accident prevention, ALGORITHMS, brain, Concussion, Constrained optimization, Design, Design optimization, finite element analysis, Finite element method, football helmet, Fuel additives, Genetic algorithms, Multiobjective optimization, Optimization, Safety devices, Shear strain, Sports, Surrogate model, Surrogate modeling, Topology, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Effgen, G B; Ong, T; Nammalwar, S; Ortuño, A I; Meaney, D F; Bass, C R D; Morrison, B

Primary Blast Exposure Increases Hippocampal Vulnerability to Subsequent Exposure: Reducing Long-Term Potentiation Journal Article

In: Journal of Neurotrauma, vol. 33, no. 20, pp. 1901–1912, 2016.

Abstract | Links | BibTeX | Tags: blast, brain, glia neuron, plasticity

@article{Effgen2016,

title = {Primary Blast Exposure Increases Hippocampal Vulnerability to Subsequent Exposure: Reducing Long-Term Potentiation},

author = {Effgen, G B and Ong, T and Nammalwar, S and Ortu\~{n}o, A I and Meaney, D F and Bass, C R D and Morrison, B},

doi = {10.1089/neu.2015.4327},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Neurotrauma},

volume = {33},

number = {20},

pages = {1901--1912},

abstract = {Up to 80% of injuries sustained by U.S. soldiers in Operation Enduring Freedom and Operation Iraqi Freedom were the result of blast exposure from improvised explosive devices. Some soldiers experience multiple blasts while on duty, and it has been suggested that symptoms of repetitive blast are similar to those that follow multiple non-blast concussions, such as sport-related concussion. Despite the interest in the effects of repetitive blast exposure, it remains unknown whether an initial blast renders the brain more vulnerable to subsequent exposure, resulting in a synergistic injury response. To investigate the effect of multiple primary blasts on the brain, organotypic hippocampal slice cultures were exposed to single or repetitive (two or three total) primary blasts of varying intensities. Long-term potentiation was significantly reduced following two Level 2 (92.7 kPa, 1.4 msec, 38.5 kPa·msec) blasts delivered 24 h apart without altering basal evoked response. This deficit persisted when the interval between injuries was increased to 72 h but not when the interval was extended to 144 h. The repeated blast exposure with a 24 h interval increased microglia staining and activation significantly but did not significantly increase cell death or damage axons, dendrites, or principal cell layers. Lack of overt structural damage and change in basal stimulated neuron response suggest that injury from repetitive primary blast exposure may specifically affect long-term potentiation. Our studies suggest repetitive primary blasts can exacerbate injury dependent on the injury severity and interval between exposures. © 2016, Mary Ann Liebert, Inc.},

keywords = {blast, brain, glia neuron, plasticity},

pubstate = {published},

tppubtype = {article}

}

Le Berre, A P; Sullivan, E V

Anosognosia for Memory Impairment in Addiction: Insights from Neuroimaging and Neuropsychological Assessment of Metamemory Journal Article

In: Neuropsychology Review, vol. 26, no. 4, pp. 420–431, 2016.

Abstract | Links | BibTeX | Tags: Alcoholism, Anosognosia, brain, Memory, Metamemory

@article{LeBerre2016,

title = {Anosognosia for Memory Impairment in Addiction: Insights from Neuroimaging and Neuropsychological Assessment of Metamemory},

author = {{Le Berre}, A P and Sullivan, E V},

doi = {10.1007/s11065-016-9323-3},

year  = {2016},

date = {2016-01-01},

journal = {Neuropsychology Review},

volume = {26},

number = {4},

pages = {420--431},

abstract = {In addiction, notably Alcohol Use Disorder (AUD), patients often have a tendency to fail to acknowledge the reality of the disease and to minimize the physical, psychological, and social difficulties attendant to chronic alcohol consumption. This lack of awareness can reduce the chances of initiating and maintaining sobriety. Presented here is a model focusing on compromised awareness in individuals with AUD of mild to moderate cognitive deficits, in particular, for episodic memory impairment\textemdashthe ability to learn new information, such as recent personal experiences. Early in abstinence, alcoholics can be unaware of their memory deficits and overestimate their mnemonic capacities, which can be investigated with metamemory paradigms. Relevant neuropsychological and neuroimaging results considered suggest that the alcoholics’ impairment of awareness of their attenuated memory function can be a clinical manifestation explained mechanistically by neurobiological factors, including compromise of brain systems that result in a mild form of mnemonic anosognosia. Specifically, unawareness of memory impairment in AUD may result from a lack of personal knowledge updating attributable to damage in brain regions or connections supporting conscious recollection in episodic memory. Likely candidates are posterior parietal and medial frontal regions known to be integral part of the Default Mode Network (DMN) and the insula leading to an impaired switching mechanism between the DMN and the Central-Executive Control (i.e., Lateral Prefronto-Parietal) Network. The cognitive concepts and neural substrates noted for addictive disorders may also be relevant for problems in self-identification of functional impairment resulting from injury following war-related blast, sport-related concussion, and insidiously occurring dementia. © 2016, Springer Science+Business Media New York.},

keywords = {Alcoholism, Anosognosia, brain, Memory, Metamemory},

pubstate = {published},

tppubtype = {article}

}

Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B

Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article

In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.

Abstract | Links | BibTeX | Tags: Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury

@article{Naeser2016,

title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},

author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},

doi = {10.1089/pho.2015.4037},

year  = {2016},

date = {2016-01-01},

journal = {Photomedicine and Laser Surgery},

volume = {34},

number = {12},

pages = {610--626},

abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},

keywords = {Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.

Chermann, J F; Savigny, A; Radafy, A; Blandin, N; Bohu, Y

In: Journal de Traumatologie du Sport, vol. 33, no. 2, pp. 88–96, 2016.

Abstract | Links | BibTeX | Tags: brain, Concussion, Sports

@article{Chermann2016,

title = {Sports-related concussion in elite athletes: Prospective study of 211 cases seen in a specialized outpatient clinic},

author = {Chermann, J F and Savigny, A and Radafy, A and Blandin, N and Bohu, Y},

doi = {10.1016/j.jts.2015.12.008},

year  = {2016},

date = {2016-01-01},

journal = {Journal de Traumatologie du Sport},

volume = {33},

number = {2},

pages = {88--96},

abstract = {Sports-related brain concussion is not well known despite its frequency. Few cases are reported. Brain concussion leads to an immediate transient alteration of the neurological functions followed by a post-concussion syndrome of variable duration. Due to the risk of neurodegenerative disease related to repeated concussion, we created a specialized outpatient clinic devoted to sports-related brain concussions in order to better apprehend the phenomenon, to search for factors predictive of unfavorable outcome, and most importantly to elaborate a protocol and a set of criteria for determining the moment the incriminated activity can be resumed under good conditions. The cohort included 211 athletes who attended the specialized outpatient clinic, 168 men and 43 women. The largest number of patients were rugby players (n = 166, 78.7%). Among the 211 athletes, 126 (59.7%) had already had one concussion and 132 attended the clinic twice, at most four days after the concussion. The diagnosis was considered on the playing field, generally because of the presence of amnesia or loss of consciousness. Among the 211 athletes, 106 (50.2%) left the field immediately after the concussion. For the post-concussion syndrome, headache was the most common functional sign (170/211, 80.6%). Age (\< 20 years), female gender, and recent history of a brain concussion were factors predictive of poor outcome as measured by the duration of the post-concussion syndrome and delay before returning to the sports activity. Loss of consciousness, anterograde or retrograde amnesia, and the number of episodes of prior brain concussion did not have any impact on the duration of the post-concussion syndrome and delay before returning to the sports activity. In our opinion, a specialized outpatient clinic visit less than four days after the concussion can help reduce the length of the post-concussion syndrome, mainly resulting from good patient education and better therapeutic management. © 2016},

keywords = {brain, Concussion, Sports},

pubstate = {published},

tppubtype = {article}

}

Sports-related brain concussion is not well known despite its frequency. Few cases are reported. Brain concussion leads to an immediate transient alteration of the neurological functions followed by a post-concussion syndrome of variable duration. Due to the risk of neurodegenerative disease related to repeated concussion, we created a specialized outpatient clinic devoted to sports-related brain concussions in order to better apprehend the phenomenon, to search for factors predictive of unfavorable outcome, and most importantly to elaborate a protocol and a set of criteria for determining the moment the incriminated activity can be resumed under good conditions. The cohort included 211 athletes who attended the specialized outpatient clinic, 168 men and 43 women. The largest number of patients were rugby players (n = 166, 78.7%). Among the 211 athletes, 126 (59.7%) had already had one concussion and 132 attended the clinic twice, at most four days after the concussion. The diagnosis was considered on the playing field, generally because of the presence of amnesia or loss of consciousness. Among the 211 athletes, 106 (50.2%) left the field immediately after the concussion. For the post-concussion syndrome, headache was the most common functional sign (170/211, 80.6%). Age (< 20 years), female gender, and recent history of a brain concussion were factors predictive of poor outcome as measured by the duration of the post-concussion syndrome and delay before returning to the sports activity. Loss of consciousness, anterograde or retrograde amnesia, and the number of episodes of prior brain concussion did not have any impact on the duration of the post-concussion syndrome and delay before returning to the sports activity. In our opinion, a specialized outpatient clinic visit less than four days after the concussion can help reduce the length of the post-concussion syndrome, mainly resulting from good patient education and better therapeutic management. © 2016

Keener, A B

Tackling the brain: Clues emerge about the pathology of sports-related brain trauma Journal Article

In: Nature Medicine, vol. 22, no. 4, pp. 326–329, 2016.

Links | BibTeX | Tags: amnesia, Article, astrocyte, athlete, Athletic Injuries, behavior change, blood vessel injury, brain, Brain Injuries, Brain Injury, cognitive defect, Concussion, confusion, degenerative disease, Epilepsy, head injury, headache, hearing impairment, human, Humans, Neck pain, nerve cell, nervous system inflammation, neurofibrillary tangle, nonhuman, Pathophysiology, postconcussion syndrome, priority journal, sport injury, traumatic brain injury, unsteadiness, Vision, wrestling

Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H

Traumatic brain injuries Journal Article

In: Nature Reviews Disease Primers, vol. 2, 2016.

Abstract | Links | BibTeX | Tags: amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury

@article{Blennow2016,

title = {Traumatic brain injuries},

author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},

doi = {10.1038/nrdp.2016.84},

year  = {2016},

date = {2016-01-01},

journal = {Nature Reviews Disease Primers},

volume = {2},

abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},

keywords = {amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

2015

Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D

Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article

In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.

Abstract | Links | BibTeX | Tags: Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)

@article{Stemper2015,

title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},

author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},

doi = {10.1007/s10439-014-1171-9},

year  = {2015},

date = {2015-01-01},

journal = {Annals of Biomedical Engineering},

volume = {43},

number = {5},

pages = {1071--1088},

abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},

keywords = {Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)},

pubstate = {published},

tppubtype = {article}

}

A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague–Dawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).

Liu, C Y; Law, M; Romano, R

Rational approach to understanding and preventing sports-related traumatic brain injuries Journal Article

In: World Neurosurgery, vol. 84, no. 6, pp. 1556–1557, 2015.

Links | BibTeX | Tags: accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance

Patton, D A; McIntosh, A S; Kleiven, S

The biomechanical determinants of concussion: Finite element simulations to investigate tissue-level predictors of injury during sporting impacts to the unprotected head Journal Article

In: Journal of Applied Biomechanics, vol. 31, no. 4, pp. 264–268, 2015.

Abstract | Links | BibTeX | Tags: Article, Biomechanics, brain, Brain Injury, brain region, clinical article, Concussion, corpus callosum, Damage detection, evaluation study, finite element analysis, Finite element head models, Finite element method, Finite element simulations, football, gray matter, Head Injuries, head injury, human, Intra-cranial pressure, intracranial pressure, investigative procedures, Maximum principal strain, mesencephalon, Modeling, Models, Numerical reconstruction, Qualitative observations, Sport, sport injury, Sports, Strain and strain rates, Strain rate, Stress, thalamus, Tissue, tissue level

@article{Patton2015,

title = {The biomechanical determinants of concussion: Finite element simulations to investigate tissue-level predictors of injury during sporting impacts to the unprotected head},

author = {Patton, D A and McIntosh, A S and Kleiven, S},

doi = {10.1123/jab.2014-0223},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Applied Biomechanics},

volume = {31},

number = {4},

pages = {264--268},

abstract = {Biomechanical studies of concussions have progressed from qualitative observations of head impacts to physical and numerical reconstructions, direct impact measurements, and finite element analyses. Supplementary to a previous study, which investigated maximum principal strain, the current study used a detailed finite element head model to simulate unhelmeted concussion and no-injury head impacts and evaluate the effectiveness of various tissue-level brain injury predictors: strain rate, product of strain and strain rate, cumulative strain damage measure, von Mises stress, and intracranial pressure. Von Mises stress was found to be the most effective predictor of concussion. It was also found that the thalamus and corpus callosum were brain regions with strong associations with concussion. Tentative tolerance limits for tissue-level predictors were proposed in an attempt to broaden the understanding of unhelmeted concussions. For the thalamus, tolerance limits were proposed for a 50% likelihood of concussion: 2.24 kPa, 24.0 s-1, and 2.49 s-1 for von Mises stress, strain rate, and the product of strain and strain rate, respectively. For the corpus callosum, tolerance limits were proposed for a 50% likelihood of concussion: 3.51 kPa, 25.1 s-1, and 2.76 s-1 for von Mises stress, strain rate, and the product of strain and strain rate, respectively. © 2015 Human Kinetics, Inc.},

keywords = {Article, Biomechanics, brain, Brain Injury, brain region, clinical article, Concussion, corpus callosum, Damage detection, evaluation study, finite element analysis, Finite element head models, Finite element method, Finite element simulations, football, gray matter, Head Injuries, head injury, human, Intra-cranial pressure, intracranial pressure, investigative procedures, Maximum principal strain, mesencephalon, Modeling, Models, Numerical reconstruction, Qualitative observations, Sport, sport injury, Sports, Strain and strain rates, Strain rate, Stress, thalamus, Tissue, tissue level},

pubstate = {published},

tppubtype = {article}

}

Jackson, K; Rubin, R; Van Hoeck, N; Hauert, T; Lana, V; Wang, H

The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers Journal Article

In: Translational Neuroscience, vol. 6, no. 1, pp. 131–138, 2015.

Abstract | Links | BibTeX | Tags: adult, Article, Athletics, body temperature, body temperature measurement, brain, brain temperature, clinical assessment, clinical effectiveness, cognition, cold tolerance, cold treatment, Concussion, diastolic blood pressure, executive function, Feasibility, Female, head neck cooling, Heart Rate, human, human experiment, infrared thermometer, Intervention, Male, mouth temperature, normal human, physiological process, priority journal, pulse oximetry, room temperature, systolic blood pressure, TASK performance, temperature management device, thermoregulation, tympanic temperature, velocity, welkins emt temperature management system, working memory

@article{Jackson2015,

title = {The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers},

author = {Jackson, K and Rubin, R and {Van Hoeck}, N and Hauert, T and Lana, V and Wang, H},

doi = {10.1515/tnsci-2015-0012},

year  = {2015},

date = {2015-01-01},

journal = {Translational Neuroscience},

volume = {6},

number = {1},

pages = {131--138},

abstract = {In general, brain temperatures are elevated during physical sporting activities; therefore, reducing brain temperature shortly after a sports-related concussion (SRC) could be a promising intervention technique. The main objective of this study was to examine the effects of head and neck cooling on physiological and cognitive function in normal healthy volunteers. Twelve healthy volunteers underwent two different sessions of combined head and neck cooling, one session with a cold pack and one session with a room temperature pack. Physiological measurements included: systolic/diastolic blood pressure, pulse oximetry, heart rate, and sublingual and tympanic temperature. Cognitive assessment included: processing speed, executive function, and working memory tasks. Physiological measurements were taken pre-, mid- and post-cooling, while cognitive assessments were done before and after cooling. The order of the sessions was randomized. There was a significant decrease in tympanic temperature across both sessions; however more cooling occurred when the cold pack was in the device. There was no significant decrease in sublingual temperature across either session. The observed heart rates, pulse oximetry, systolic and diastolic blood pressure during the sessions were all within range of a normal healthy adult. Cognitive assessment remained stable across each session for both pre- and post-cooling. We propose that optimizing brain temperature management after brain injury using head and neck cooling technology may represent a sensible, practical, and effective strategy to potentially enhance recovery and perhaps minimize the subsequent short and long term consequences from SRC. © 2015 Kevin Jackson et al.},

keywords = {adult, Article, Athletics, body temperature, body temperature measurement, brain, brain temperature, clinical assessment, clinical effectiveness, cognition, cold tolerance, cold treatment, Concussion, diastolic blood pressure, executive function, Feasibility, Female, head neck cooling, Heart Rate, human, human experiment, infrared thermometer, Intervention, Male, mouth temperature, normal human, physiological process, priority journal, pulse oximetry, room temperature, systolic blood pressure, TASK performance, temperature management device, thermoregulation, tympanic temperature, velocity, welkins emt temperature management system, working memory},

pubstate = {published},

tppubtype = {article}

}

Andre, J B

Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article

In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.

Abstract | BibTeX | Tags: Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter

@article{Andre2015,

title = {Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials},

author = {Andre, J B},

year  = {2015},

date = {2015-01-01},

journal = {Topics in Magnetic Resonance Imaging},

volume = {24},

number = {5},

pages = {275--287},

abstract = {Traumatic brain injury (TBI), including concussion, is a public health concern, as it affects over 1.7 million persons in the United States per year. Yet, the diagnosis of TBI, particularly mild TBI (mTBI), can be controversial, as neuroimaging findings can be sparse on conventional magnetic resonance and computed tomography examinations, and when present, often poorly correlate with clinical signs and symptoms. Furthermore, the discussion of TBI, concussion, and head impact exposure is immediately complicated by the many differing opinions of what constitutes each, their respective severities, and how the underlying biomechanics of the inciting head impact might alter the distribution, severity, and prognosis of the underlying brain injury. Advanced imaging methodologies hold promise in improving the sensitivity and detectability of associated imaging biomarkers that might better correlate with patient outcome and prognostication, allowing for improved triage and therapeutic guidance in the setting of TBI, particularly in mTBI. This work will examine the defining symptom complex associated with mTBI and explore changes in cerebral blood flow measured by arterial spin labeling, as a potential imaging biomarker for TBI, and briefly correlate these observations with findings identified by single photon emission computed tomography and positron emission tomography imaging.. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter},

pubstate = {published},

tppubtype = {article}

}

Dang, H; Stayman, J W; Sisniega, A; Xu, J; Zbijewski, W; Wang, X; Foos, D H; Aygun, N; Koliatsos, V E; Siewerdsen, J H

Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging Journal Article

In: Physics in Medicine and Biology, vol. 60, no. 16, pp. 6153–6175, 2015.

Abstract | Links | BibTeX | Tags: artifact correction, brain, Computerized tomography, cone-beam CT, Flat panel displays, image processing, Image quality, Image reconstruction, Intensive care units, intracranial hemorrhage, Intracranial hemorrhages, Iterative methods, Least squares approximations, Measurement Noise, measurement noise model, Model based iterative reconstruction, model-based iterative reconstruction, Soft tissue, soft-tissue image quality, Tissue, Traumatic Brain Injuries, traumatic brain injury

@article{Dang2015,

title = {Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging},

author = {Dang, H and Stayman, J W and Sisniega, A and Xu, J and Zbijewski, W and Wang, X and Foos, D H and Aygun, N and Koliatsos, V E and Siewerdsen, J H},

doi = {10.1088/0031-9155/60/16/6153},

year  = {2015},

date = {2015-01-01},

journal = {Physics in Medicine and Biology},

volume = {60},

number = {16},

pages = {6153--6175},

abstract = {Non-contrast CT reliably detects fresh blood in the brain and is the current front-line imaging modality for intracranial hemorrhage such as that occurring in acute traumatic brain injury (contrast ∼40-80 HU, size \> 1 mm). We are developing flat-panel detector (FPD) cone-beam CT (CBCT) to facilitate such diagnosis in a low-cost, mobile platform suitable for point-of-care deployment. Such a system may offer benefits in the ICU, urgent care/concussion clinic, ambulance, and sports and military theatres. However, current FPD-CBCT systems face significant challenges that confound low-contrast, soft-tissue imaging. Artifact correction can overcome major sources of bias in FPD-CBCT but imparts noise amplification in filtered backprojection (FBP). Model-based reconstruction improves soft-tissue image quality compared to FBP by leveraging a high-fidelity forward model and image regularization. In this work, we develop a novel penalized weighted least-squares (PWLS) image reconstruction method with a noise model that includes accurate modeling of the noise characteristics associated with the two dominant artifact corrections (scatter and beam-hardening) in CBCT and utilizes modified weights to compensate for noise amplification imparted by each correction. Experiments included real data acquired on a FPD-CBCT test-bench and an anthropomorphic head phantom emulating intra-parenchymal hemorrhage. The proposed PWLS method demonstrated superior noise-resolution tradeoffs in comparison to FBP and PWLS with conventional weights (viz. at matched 0.50 mm spatial resolution},

keywords = {artifact correction, brain, Computerized tomography, cone-beam CT, Flat panel displays, image processing, Image quality, Image reconstruction, Intensive care units, intracranial hemorrhage, Intracranial hemorrhages, Iterative methods, Least squares approximations, Measurement Noise, measurement noise model, Model based iterative reconstruction, model-based iterative reconstruction, Soft tissue, soft-tissue image quality, Tissue, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S

Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article

In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed

@article{Morgan2015,

title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},

author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},

doi = {10.1007/s00381-015-2916-y},

year  = {2015},

date = {2015-01-01},

journal = {Child's Nervous System},

volume = {31},

number = {12},

pages = {2305--2309},

abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},

keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},

pubstate = {published},

tppubtype = {article}

}

Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D

A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma Journal Article

In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.

Abstract | Links | BibTeX | Tags: accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult

@article{Oeur2015,

title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},

author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},

doi = {10.3171/2014.10.JNS14440},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery},

volume = {123},

number = {2},

pages = {415--422},

abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},

keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p < 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p < 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.