Forces of Traumatic Brain Injury

Brain Injuries often occur fast (in milliseconds) to small places in the brain (microscopic cells).   Speed and size require specific understanding in relation to forces.  This must be important to all of us since just a moment of inattention can result in significant forces being imposed on our heads.  Think of the truck or car crash you did not see coming.  Or the fall you took.  The resulting impacts can change our brains and cause a whole constellation of symptoms and consequences.

Biomechanical forces  (the research and analysis of the mechanics of living organisms and the application of engineering principles to and from biological systems) to the head and body are predictors of brain injury.  In cases of trauma, like car, motorcycle and truck collisions, in addition to sports trauma, like hockey, football and boxing (to name a few), the amount of pressure exerted on the head and the amount of time that elapses during the application of pressure, cause microscopic changes to the structure of the brain.  Microscopic because the damage occurs at the cellular level with axons and dendrites shearing. 

This, in turn, causes metabolic changes (biochemical processes) and other changes in chemistry that result in cognitive impairments, emotional impairments and physical impairments.

Head injury expert Kim Gorgens, a neuropsychologist at the University of Denver (DU), says that most concussions deliver 95 g's to the human body upon impact.

Concussions range in significance from minor to major, but they all share one common factor — they temporarily interfere with the way your brain works. They can affect memory, judgment, reflexes, speech, balance and coordination.

Usually caused by a blow to the head, concussions don't always involve a loss of consciousness. In fact, most people who have concussions never black out. Some people have had concussions and not even realized it.

Concussions are common, particularly if you play a contact sport such as football. But every concussion, no matter how mild, injures your brain. This injury needs time and rest to heal properly. Luckily, most concussions are mild and people usually recover fully.

G-force is a unit of force equal to the force exerted by gravity. In addition, the average football player receives 103 g's when hit during a game. In comparison, the average g-force experienced by military fighter pilots is nine g's. 

Let that sink in for perspective.
 

Children and Brain Injury

Can Children Under 3 have Measurable Brain Damage?

Florida lawyers Rinaldo Law Group http://www.tampaaccidentattorney-rinaldolawgroup.com/ asks the about brain injury in very young children.

 

I am a personal injury attorney in Florida. Given your experience, I would be very interested to know if you agree that there are even greater challenges in a brain trauma case involving a child under three years of age. At what age do you believe they are old enough to build a credible case. We have have had some very rewarding but extremely challenging cases in this area in the past so your comments would be appreciated. Thank you.

 

Other bloggers comment on the issues: For instance braininjury.com states the following:

 

Brain Injury in children under 3 is difficult to detect in mild and moderate incidences. Unfortunately, head injuries are very common with children, accounting for approximately one hundred thousand hospitalizations annually. Trauma and come injury result from car accidents, bicycle accidents, falls, sporting injuries, and child abuse.

 

Certain aspects of brain injury are unique to children. For example, it is more difficult to determine the measure the loss of brain function in a child. In adults there are prior academic records, I.Q. scores, and job histories to rely on. At one time it was assumed that children were more resistant to brain trauma than adults because their developing brains could rewire over time. However, mounting evidence seems to suggest otherwise. In fact, it may be that children are more susceptible than adults to permanent brain damage even when the forces involved are equivalent.

 

The Center for Neuroskills provides a site regarding very young children. The National Pediatric Trauma Registry reported “approximately one-third of all pediatric injury cases are related to

brain injury (1993).”

 

In these cases, finding a neurologist with specific interest and experience in pediatric neurology is a must. William Singer M.D. is out of Massachusetts and is a highly sought pediatric neurologist. I have worked with him on a number of my pediatric cases.

 

MassGeneral Hospital for Children pediatric neurologists treat children with seizure disorders, developmental delay, chronic headaches, attention and learning disorders, metabolic, and genetic disorders. These problems are often complex and may involve multiple physical and emotional factors.

 

Drs. Silken and Singer provide outpatient consultations in their offices, not on-site at Newton-Wellesley. Appointments may be scheduled by calling the numbers listed below. Both physicians utilize Newton-Wellesley’s state-of-the-art neurodiagnostic facilities, including MRI, CT, and neurophysiologic testing facilities.

William Singer, MD
The Center for Developmental Neurology & Pediatric Behavioral Medicine
42 Washington Street
Suite 100, Wellesley, MA 02481

MD Degree: State University of New York College of Medicine, 1970
Residency: State University of New York,  Pediatrics, 1972
Fellowship: New England Medical Center, Pediatric Neurology, 1972-1975
Board Certification:
Pediatrics
Clinical Interests: Traumatic brain injury

Research Detecting Spine Injury in Children in Car Accidents

 New research published this month in the journal Injury finds that while fatal cervical spine injuries to children in motor vehicle crashes are rare, they are more commonly seen in girls, in children who were restrained in passenger restraints, and in children who also suffered traumatic brain injury due to the crash (see also Pediatrics).

Researchers from The Children's Hospital of Philadelphia, The University of Pennsylvania and Ohio State University Medical Center studied 6,065 children younger than 16 years old and found that only 2.9% of the fatalities involved a cervical spine injury.

This study represents the first time a research team has used a linked version of two previously independent data sets from the Centers for Disease Control (CDC) and the National Highway Transportation Safety Administration (NHTSA) to enable in-depth analysis of the relationship between crash characteristics such as speed or vehicle type, and type of injury (including CSI) for fatally injured children. The two large national mortality databases used were the Fatality Analysis Reporting System (FARS) and Multiple Cause-of-Death (MCOD) datasets.

 Read the entire article: "Research Consortium Advances Understanding of Cervical Spine Injuries in Children Involved in Motor Vehicle Crashes.(Report)." Health & Medicine Week. NewsRX. 2009. HighBeam Research. 11 Sep. 2009 <http://www.highbeam.com>.

Did You Know?

DID YOU KNOW?

  • A concussion is the most common type of brain injury sustained in sports.
  • Most concussions do NOT involve loss of consciousness.
  • You can sustain a concussion even if you do NOT hit your head. An indirect blow elsewhere on the body can transmit an “impulsive” force to the head and cause a concussion to the brain.
  • Multiple concussions can have cumulative and long lasting life changes.
  • Concussions typically do NOT appear in neuroimaging studies such as MRI or CAT Scans.
  • An estimated 1.6-3.8 million sports- and recreation-related concussions occur in the United States each year.
  • During 2001-2005, children and youth ages 5–18 years accounted for 2.4 million sports-related emergency department (ED) visits annually, of which 6% (135,000) involved a concussion.
  • Of the 1.4 million traumatic brain injuries sustained by children and adults in the United States each year, at least 75% are mild and/or concussions.
  • Among children and youth ages 5–18 years, the five leading sports or recreational activities, which account for concussions, include bicycling, football, basketball, playground activities, and soccer.