Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention & Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {*Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention \& Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
Abstract | Links | BibTeX | Tags: Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident},
pubstate = {published},
tppubtype = {article}
}
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}
}
Bigler, Erin D; Deibert, Ellen
Lesion analysis in mild traumatic brain injury: Old school goes high tech Journal Article
In: Neurology, vol. 83, no. 14, pp. 1226–1227, 2014, ISBN: 0028-3878 1526-632X.
Abstract | Links | BibTeX | Tags: 2014, ALGORITHMS, brain, functional magnetic resonance imaging, gray matter, mild traumatic brain injury, MRI, traumatic brain injury, white matter
@article{Bigler2014,
title = {Lesion analysis in mild traumatic brain injury: Old school goes high tech},
author = {Bigler, Erin D and Deibert, Ellen},
doi = {10.1212/WNL.0000000000000848},
isbn = {0028-3878
1526-632X},
year = {2014},
date = {2014-01-01},
journal = {Neurology},
volume = {83},
number = {14},
pages = {1226--1227},
publisher = {Lippincott Williams \& Wilkins},
address = {US},
abstract = {Comments on an article by Y. W. Lui et al. (see record [rid]2014-43480-004[/rid]). Concussion has been a controversial topic in neurology since the beginning of the discipline. Evidence based diagnostic guidelines have been established,1 but the diagnosis and treatment are largely grounded in clinical decision-making. Clinical and research issues around sports concussion have even reached the levels of government policy with the White House. At the moderate to severe range of traumatic brain injury, neuroimaging provides well-established, objective pathoanatomical biomarkers of the injury. In contrast, conventional neuroimaging findings in mTBI are typically absent. The cognitive and neurobehavioral symptoms of mTBI overlap with any number of neurologic or psychiatric disorders, providing no definitive marker of injury or for tracking injury effects. Reliable biomarkers of mTBI could lead to better clinical decision-making and potential treatments. Deformation-based biomechanical studies of mTBI have shown the thalamus is situated in a particularly vulnerable zone. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},
keywords = {2014, ALGORITHMS, brain, functional magnetic resonance imaging, gray matter, mild traumatic brain injury, MRI, traumatic brain injury, white matter},
pubstate = {published},
tppubtype = {article}
}
Bartsch, A; Samorezov, S; Benzel, E; Miele, V; Brett, D
Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter Journal Article
In: Stapp Car Crash Journal, vol. 58, pp. 1–27, 2014.
Abstract | BibTeX | Tags: *Acceleration, *Boxing, *Brain Injuries, *Football, *Mouth Protectors, *Telemetry, ALGORITHMS, Biomechanical Phenomena/ph [Physiology], Boxing/in [Injuries], Boxing/ph [Physiology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Brain Injuries/pc [Prevention & Control], Brain Injuries/pp [Physiopathology], finite element analysis, Football/in [Injuries], Football/ph [Physiology], Head Protective Devices, Humans, Reproducibility of Results, Telemetry/is [Instrumentation], Telemetry/mt [Methods]
@article{Bartsch2014,
title = {Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter},
author = {Bartsch, A and Samorezov, S and Benzel, E and Miele, V and Brett, D},
year = {2014},
date = {2014-01-01},
journal = {Stapp Car Crash Journal},
volume = {58},
pages = {1--27},
abstract = {Dating to Colonel John Paul Stapp MD in 1975, scientists have desired to measure live human head impacts with accuracy and precision. But no instrument exists to accurately and precisely quantify single head impact events. Our goal is to develop a practical single event head impact dosimeter known as "Intelligent Mouthguard" and quantify its performance on the benchtop, in vitro and in vivo. In the Intelligent Mouthguard hardware, limited gyroscope bandwidth requires an algorithm-based correction as a function of impact duration. After we apply gyroscope correction algorithm, Intelligent Mouthguard results at time of CG linear acceleration peak correlate to the Reference Hybrid III within our tested range of pulse durations and impact acceleration profiles in American football and Boxing in vitro tests: American football},
keywords = {*Acceleration, *Boxing, *Brain Injuries, *Football, *Mouth Protectors, *Telemetry, ALGORITHMS, Biomechanical Phenomena/ph [Physiology], Boxing/in [Injuries], Boxing/ph [Physiology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Brain Injuries/pc [Prevention \& Control], Brain Injuries/pp [Physiopathology], finite element analysis, Football/in [Injuries], Football/ph [Physiology], Head Protective Devices, Humans, Reproducibility of Results, Telemetry/is [Instrumentation], Telemetry/mt [Methods]},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
Bigler, Erin D; Deibert, Ellen
Lesion analysis in mild traumatic brain injury: Old school goes high tech Journal Article
In: Neurology, vol. 83, no. 14, pp. 1226–1227, 2014, ISBN: 0028-3878 1526-632X.
@article{Bigler2014,
title = {Lesion analysis in mild traumatic brain injury: Old school goes high tech},
author = {Bigler, Erin D and Deibert, Ellen},
doi = {10.1212/WNL.0000000000000848},
isbn = {0028-3878
1526-632X},
year = {2014},
date = {2014-01-01},
journal = {Neurology},
volume = {83},
number = {14},
pages = {1226--1227},
publisher = {Lippincott Williams \& Wilkins},
address = {US},
abstract = {Comments on an article by Y. W. Lui et al. (see record [rid]2014-43480-004[/rid]). Concussion has been a controversial topic in neurology since the beginning of the discipline. Evidence based diagnostic guidelines have been established,1 but the diagnosis and treatment are largely grounded in clinical decision-making. Clinical and research issues around sports concussion have even reached the levels of government policy with the White House. At the moderate to severe range of traumatic brain injury, neuroimaging provides well-established, objective pathoanatomical biomarkers of the injury. In contrast, conventional neuroimaging findings in mTBI are typically absent. The cognitive and neurobehavioral symptoms of mTBI overlap with any number of neurologic or psychiatric disorders, providing no definitive marker of injury or for tracking injury effects. Reliable biomarkers of mTBI could lead to better clinical decision-making and potential treatments. Deformation-based biomechanical studies of mTBI have shown the thalamus is situated in a particularly vulnerable zone. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bartsch, A; Samorezov, S; Benzel, E; Miele, V; Brett, D
Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter Journal Article
In: Stapp Car Crash Journal, vol. 58, pp. 1–27, 2014.
@article{Bartsch2014,
title = {Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter},
author = {Bartsch, A and Samorezov, S and Benzel, E and Miele, V and Brett, D},
year = {2014},
date = {2014-01-01},
journal = {Stapp Car Crash Journal},
volume = {58},
pages = {1--27},
abstract = {Dating to Colonel John Paul Stapp MD in 1975, scientists have desired to measure live human head impacts with accuracy and precision. But no instrument exists to accurately and precisely quantify single head impact events. Our goal is to develop a practical single event head impact dosimeter known as "Intelligent Mouthguard" and quantify its performance on the benchtop, in vitro and in vivo. In the Intelligent Mouthguard hardware, limited gyroscope bandwidth requires an algorithm-based correction as a function of impact duration. After we apply gyroscope correction algorithm, Intelligent Mouthguard results at time of CG linear acceleration peak correlate to the Reference Hybrid III within our tested range of pulse durations and impact acceleration profiles in American football and Boxing in vitro tests: American football},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention & Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {*Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention \& Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
Abstract | Links | BibTeX | Tags: Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident},
pubstate = {published},
tppubtype = {article}
}
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}
}
Bigler, Erin D; Deibert, Ellen
Lesion analysis in mild traumatic brain injury: Old school goes high tech Journal Article
In: Neurology, vol. 83, no. 14, pp. 1226–1227, 2014, ISBN: 0028-3878 1526-632X.
Abstract | Links | BibTeX | Tags: 2014, ALGORITHMS, brain, functional magnetic resonance imaging, gray matter, mild traumatic brain injury, MRI, traumatic brain injury, white matter
@article{Bigler2014,
title = {Lesion analysis in mild traumatic brain injury: Old school goes high tech},
author = {Bigler, Erin D and Deibert, Ellen},
doi = {10.1212/WNL.0000000000000848},
isbn = {0028-3878
1526-632X},
year = {2014},
date = {2014-01-01},
journal = {Neurology},
volume = {83},
number = {14},
pages = {1226--1227},
publisher = {Lippincott Williams \& Wilkins},
address = {US},
abstract = {Comments on an article by Y. W. Lui et al. (see record [rid]2014-43480-004[/rid]). Concussion has been a controversial topic in neurology since the beginning of the discipline. Evidence based diagnostic guidelines have been established,1 but the diagnosis and treatment are largely grounded in clinical decision-making. Clinical and research issues around sports concussion have even reached the levels of government policy with the White House. At the moderate to severe range of traumatic brain injury, neuroimaging provides well-established, objective pathoanatomical biomarkers of the injury. In contrast, conventional neuroimaging findings in mTBI are typically absent. The cognitive and neurobehavioral symptoms of mTBI overlap with any number of neurologic or psychiatric disorders, providing no definitive marker of injury or for tracking injury effects. Reliable biomarkers of mTBI could lead to better clinical decision-making and potential treatments. Deformation-based biomechanical studies of mTBI have shown the thalamus is situated in a particularly vulnerable zone. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},
keywords = {2014, ALGORITHMS, brain, functional magnetic resonance imaging, gray matter, mild traumatic brain injury, MRI, traumatic brain injury, white matter},
pubstate = {published},
tppubtype = {article}
}
Bartsch, A; Samorezov, S; Benzel, E; Miele, V; Brett, D
Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter Journal Article
In: Stapp Car Crash Journal, vol. 58, pp. 1–27, 2014.
Abstract | BibTeX | Tags: *Acceleration, *Boxing, *Brain Injuries, *Football, *Mouth Protectors, *Telemetry, ALGORITHMS, Biomechanical Phenomena/ph [Physiology], Boxing/in [Injuries], Boxing/ph [Physiology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Brain Injuries/pc [Prevention & Control], Brain Injuries/pp [Physiopathology], finite element analysis, Football/in [Injuries], Football/ph [Physiology], Head Protective Devices, Humans, Reproducibility of Results, Telemetry/is [Instrumentation], Telemetry/mt [Methods]
@article{Bartsch2014,
title = {Validation of an "Intelligent Mouthguard" Single Event Head Impact Dosimeter},
author = {Bartsch, A and Samorezov, S and Benzel, E and Miele, V and Brett, D},
year = {2014},
date = {2014-01-01},
journal = {Stapp Car Crash Journal},
volume = {58},
pages = {1--27},
abstract = {Dating to Colonel John Paul Stapp MD in 1975, scientists have desired to measure live human head impacts with accuracy and precision. But no instrument exists to accurately and precisely quantify single head impact events. Our goal is to develop a practical single event head impact dosimeter known as "Intelligent Mouthguard" and quantify its performance on the benchtop, in vitro and in vivo. In the Intelligent Mouthguard hardware, limited gyroscope bandwidth requires an algorithm-based correction as a function of impact duration. After we apply gyroscope correction algorithm, Intelligent Mouthguard results at time of CG linear acceleration peak correlate to the Reference Hybrid III within our tested range of pulse durations and impact acceleration profiles in American football and Boxing in vitro tests: American football},
keywords = {*Acceleration, *Boxing, *Brain Injuries, *Football, *Mouth Protectors, *Telemetry, ALGORITHMS, Biomechanical Phenomena/ph [Physiology], Boxing/in [Injuries], Boxing/ph [Physiology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Brain Injuries/pc [Prevention \& Control], Brain Injuries/pp [Physiopathology], finite element analysis, Football/in [Injuries], Football/ph [Physiology], Head Protective Devices, Humans, Reproducibility of Results, Telemetry/is [Instrumentation], Telemetry/mt [Methods]},
pubstate = {published},
tppubtype = {article}
}