A Proposed Injury Threshold for Mild Traumatic Brain Injury

[+] Author and Article Information
Liying Zhang, King H. Yang, Albert I. King

Bioengineering Center, Wayne State University, Detroit, Michigan 48202

J Biomech Eng 126(2), 226-236 (May 04, 2004) (11 pages) doi:10.1115/1.1691446 History: Received February 12, 2002; Revised November 26, 2003; Online May 04, 2004
Copyright © 2004 by ASME
Your Session has timed out. Please sign back in to continue.


Kraus,  J. F., and McArthur,  D. L., 1996, “Epidemiologic aspects of brain injury,” Neurol. Clin., 14(2), pp. 435–450.
Rimel,  R. W., Giordani,  B., Barth,  J. T., Boll,  T. J., and Jane,  J. A., 1981, “Disability caused by minor head injury,” Neurosurgery, 9, pp. 35–42.
Thurman,  D. J., Brance,  C. M., and Sniezek,  J. E., 1998, “The epidemiology of sports-related traumatic brain injuries in the United States: Recent developments,” J. Head Trauma Rehabil., 13(2), pp. 1–8.
Gadd, C. W., 1966, “Use of a weighted impulse criterion for estimating injury hazard,” Proceedings, 10th Stapp Car Crash Conf., pp. 164–174.
Versac, J., 1971, “A review of severity of index,” Proceedings, 15th Stapp Car Crash Conf., SAE Paper No. 710881.
Lissner,  H. R., Lebow,  M., and Evans,  F. G., 1960, “Experimental studies on the relation between acceleration and intracranial pressure changes in man,” Surg. Gynecol. Obstet., 111, pp. 329–338.
Ruan, J. S., Khalil, T. B., and King, A. I., 1993, “Finite element modeling of direct head impact,” Proceedings, 37th Stapp Car Crash Conf., SAE Paper No. 933114.
Ruan,  J. S., Khalil,  T. B., and King,  A. I., 1994, “Dynamic response of the human head to impact by three-dimensional finite element analysis,” J. Biomech. Eng., 116, pp. 44–50.
Zhou, C., Khalil, T. B., and King, A. I., 1994, “Shear stress distribution in the porcine brain due to rotational impact,” Proceedings, 38th Stapp Car Crash Conf., SAE Paper No. 942314.
Zhou, C., Khalil, T. B, and King, A. I., 1995, “A new model comparing impact responses of the homogeneous and inhomogeneous human brain,” Proceedings, 39th Stapp Car Crash Conf., SAE Paper No. 952714.
Bandak, F. A., and Eppinger, R. H., 1994, “A three-dimensional finite element analysis of the human brain under combined rotational and translational accelerations,” Proceedings, 38th Stapp Car Crash Conf., SAE Paper No. 942215.
Al-Bsharat, A., Hardy, W. N., Yang, K., Khalil, T. B., King, A. I., and Tashman, S., 1999, “Brain/skull relative displacement magnitude due to blunt head impact: new experimental data and model,” Proceedings, 43rd Stapp Car Crash Conf., SAE Paper No. 99S-86.
Newman, J., Beusenberg, M., Fournier, E., Shewchenko, N., Withnall, C., King, A., Yang, K., Zhang, L., McElhaney, J., Thibault, L., McGinnis, G., 1999, “A new biomechanical assessment of mild traumatic brain injury Part I—Methodology,” Proceedings, the IRCOBI conf., pp. 17–36.
Newman,  J. A., Shewchenko,  N., and Welbourne,  E., 2000, “A proposed new biomechanical head injury assessment function—The maximum power index,” Stapp Car Crash Journal, 44 , Paper No. 2000-01-SC16, pp. 215–247.
Newman, J. A., Shewchenko, N., Beusenberg, M. C., Fournier, E., Withnall, C., and Barr, C., 2004, “Verification of biomechanical methods employed in a comprehensive study of mild traumatic brain injury and the effectiveness of American football helmets,” Accepted for the J. Biomech., 2004.
Zhang,  L., Yang,  K. H., and King,  A. I., 2001a, “Comparison of brain responses between frontal and lateral impacts by finite element modeling,” J. Neurotrauma, 18(1), pp. 21–30.
Nahum, A. M., Smith, R., and Ward, C. C., 1977, “Intracranial pressure dynamics during head impact,” Proceedings, 21st Stapp Car Crash Conf., SAE Paper No. 770922.
Trosseille, X., Tarriere, C., Lavaste, F., Guillon, F., and Domont, A, 1992, “Development of a F.E.M. of the human head according to a specific test protocol,” Proceedings, 36th Stapp Car Crash Conf., SAE Paper No. 922527.
Arbogast, K. B. Prange, M. T., Meaney, D. F., and Margulies, S. S., 1997, “Properties of gray and white matter undergoing large deformation,” Proceedings, 7th Injury Prevention through Biomechanics Symposium, pp. 33–39.
Arbogast, K. B., and Margulies, S. S., 1997, “Regional differences in mechanical properties of the porcine central nervous system,” Proceedings, 41st Stapp Car Crash Conf., SAE Paper No. 973336.
Shock, L. Z., and Advani, S. H., 1972, “Rheological response of human brain tissue in shear,” Basic Engineering, Transaction of the American Society of Mechanical Engineers, (December), pp. 905–911.
Zhang, L., Yang, K., and King, A. I., 1999, “Recent advances in the biomechanical modeling and it’s application in brain injury study in contact sports,” Proceedings, AMERI-PAM North American Conf., pp. 531–544.
Zhang,  L., Yang,  K. H., and King,  A. I., 2001, “Biomechanics of Neurotrauma,” Neurol. Res., 23, pp. 144–156.
Pieropaoli,  C., and Basser,  P. J., 1996, “Toward a quantitative assessment of diffusion anisotropy,” Magn. Reson. Med., 36, pp. 893–906.
Hodgson, V. R., and Thomas, L. M., 1972, “Effect of long-duration impact on head,” Proceedings, 16th Stapp Car Crash Conf., SAE Paper No. 720956.
Prasad, P., and Mertz, H. J., 1985, “The position of the United States delegates to the ISO working group 6 on the use of HIC in the automotive environment,” SAE Paper No. 851246.
Mertz, H. J., and Irwin, A. L., 1994, “Brain injury risk assessment of frontal crash test results,” Occupant Protection in Crash Environment, SP-1045, SAE Paper No. 941056.
Hosmer, D. W. Jr., and Lemeshow, S., 1989, Applied Logistic Regression, John Wiley and Sons, New York.
Denney-Brown,  D., and Russell,  W. R., 1943, “Experimental cerebral concussion,” Brain, 64, pp. 93.
Holburn,  A. H. S., 1943, “Mechanics of head injuries,” Lancet, 2, pp. 438–441.
Gross,  A. G., 1958, “Impact thresholds of brain concussion,” J. Aviation Med., 29 , pp. 725–732.
Lindenberg,  R., and Freytag,  E., 1960, “Mechanism of cerebral contusion: A pathologic-anatomic study,” AMA. Arch. Pathol., 69 , pp. 440–469.
Ward, C. C., Chan, M., and Nahum, A. M., 1980, “Intracranial pressure-A brain injury criterion,” Proceedings, 24th Stapp Car Crash Conf., SAE Paper No. 801304.
Gennarelli,  T. A., Thibault,  L., Adams,  J., Graham,  D., Thompson,  C., and Marcincin,  R., 1982, “Diffuse axonal injury and traumatic coma in the primate,” Ann. Neurol., 12(6), pp. 564–574.
Strich,  S. J., 1956, “Diffuse degeneration of the cerebral white matter in severe dementia following head injury,” J. Neurol., Neurosurg. Psychiatry, 19, pp. 163–85.
Strich,  S. J., 1961, “Shearing of nerve fibres as a cause of brain damage due to head injury,” Lancet, 2, pp. 443–448.
Peerless,  S. J., and Rewcastle,  N. B., 1967, “Shear injuries of the brain,” Can. Med. Assoc. J., 96, pp. 577–582.
Maxwell,  W. L., Watt,  C., Graham,  D. I., and Gennarelli,  T. A., 1993, “Ultrastructural evidence of axonal shearing as a result of lateral acceleration of the head in non-human primates,” Acta Neuropathol., 86, pp. 136–144.
Gurdjian, E. S., Lissner, H. R., and Patrick, L. M., 1963, “Concussion-mechanism and pathology,” Proceedings, 7th Stapp Car Crash Conf., pp. 470–482.
Edberg,  S., Rieker,  J., Angrist,  A., 1963, “Study of impact pressure and acceleration in plastic skull models,” Lab. Invest., 12(12), pp. 1305–1311.
Adams,  J. H., Graham,  D. I., Murray,  L. S., and Scott,  G., 1982, “Diffuse axonal injury due to nonmissile head injury in humans, pp. an analysis of 45 cases,” Ann. Neurol., 12, pp. 557–563.
Adams,  J. H., Graham,  D. I., and Gennarelli,  T. A., 1983, “Head injury in man and experimental animals: Neuropathology,” Acta Neurochir. Suppl. (Wien), 32, pp. 15–30.
Pilz,  P., 1983, “Axonal injury in head injury,” Acta Neurochir. Suppl. (Wien), 32, pp. 119–123.
Jane,  J. A., Steward,  O., and Gennarelli,  T. A., 1985, “Axonal degeneration induced by experimental noninvasive minor head injury,” J. Neurosurg., 62, pp. 96–100.
Gennarelli, T. A., 1987, “Cerebral concussion and diffuse brain injuries,” Head Injury, Cooper, P. R., eds., Williams & Wilkin, Baltimore, pp. 137–158.
Magoun, H. M., 1958, The Walking Brain, Charles C Thomas, Springfield, Ill.
Rosenblum,  W., Greenberg,  R., Seelig,  J., and Becker,  D., 1981, “Midbrain lesion: Frequent and significant prognostic feature in closed brain injury,” Neurosurgery, 9(6), pp. 613–620.
Fallenstein,  G. T., Hulce,  V. D., and Melvin,  J. W., 1969, “Dynamic mechanical properties of human brain tissue,” J. Biomech., 2, 217–226.
Galford, J. E., McElhaney, J. H., 1969, “Some viscoelastic study of scalp,” brain and dura, ASME paper No. 69-BHF-6, American Society of Mechanical Engineers, New York.
Altman, D., 1991, Practical Statistics for Medical Research, Chapman & Hall, New York.
Kang, H-S., Willinger, R., Diaw, B. M. and Chinn, B., 1997, “Modeling of the human head under impact conditions: a parametric study,” Proceedings, 41st Stapp Car Crash Conf., SAE Paper No. 973338.
Anderson, R. W. G., Brown, C. J., Blumbergs, P. C., Scott, G., Finney, J. W., Jones, N. R., and McLean, A. J., 1999, “Mechanisms of axonal injury: an experimental and numerical study of a sheep model of head impact,” Proceedings, International Conference on the Biomechanics of Impact (IRCOBI), Sitges, Spain, pp. 107–120.
Bain,  A. C., and Meaney,  D. F., 2000, “Tissue-level thresholds for axonal damage in an experimental model of central nerve system white matter injury,” J. Biomech. Eng., 122, pp. 615–622.
Ono, K., Kikuchi, A., Nakamura, M., Kobayashi, H., and Nakamura, H., 1980, “Human head tolerance to sagittal impact reliable estimation deduced from experimental head injury using sub-human primates and human cadaver skulls,” Proceedings, 24th Stapp Car Crash Conf., pp. 101–160.
Gurdjian,  E. S., Lissner,  H. R., Hodgson,  V. R., and Patrick,  L. M., 1964, “Mechanisms of head injury,” Clin. Neurosurg., 12, pp. 112–128.
Ommaya, A. K., Yarnell, P., Hirsch, A. E., and Harris, E. H., 1967, “Scaling of experimental data on cerebral concussion in sub-human primates to concussion threshold for man,” Proceedings, 11th Stapp Car Crash Conf., SAE Paper No. 670906.
Lowenhielm,  P., 1975, “Mathematical simulation of gliding contusions,” J. Biomech., 8, pp. 351–356.
Ewing C. L., 1975, “Injury criteria and human tolerance for the neck,” Aircraft Crashworthiness, University Press of Virginia, Charlottesville, VA.
Princemaille, Y., Trosseille, X., Mack, P., Tarriere, C., Breton, F., and Renault, B., 1989, “Some new data related to human tolerance obtained from volunteer boxers,” Proceedings, 33rd Stapp Car Crash Conf., SAE Paper No. 892435.
Margulies,  S. S., and Thibault,  L. E., 1992, “A proposed tolerance criterion for diffuse axonal injury in man,” J. Biomech., 25, pp. 917–923.
Hodgson, V. R., Thomas, L. M., and Khalil, T. B., 1983, “The role of impact location in reversible cerebral concussion,” Proceedings, 27th Stapp Car Crash Conf., SAE Paper No. 831618.
Tarriere, C., 1987, “Relationships between experimental measuring techniques and real world injuries,” Report, Head Injury Mechanism Symposium, AAAM/Volvo Car Corporation, New Orleans, Louisiana, pp. 47–85.
Gennarelli, T. A., Thibault, L. E., Tomei, G., Wiser, R., Graham, D., and Adams, J., 1987, “Directional dependence of axonal brain injury due to centroidal and non-centroidal acceleration,” Proceedings, 31st Stapp Car Crash Conf., SAE Paper No. 872197.


Grahic Jump Location
Laboratory accident reconstruction set up. Helmeted headform A represents a struck player’s head and helmeted headform B represents a striking player’s head
Grahic Jump Location
Block diagram illustrating the tissue-injury response to traumatic input loading as a biomechanical analysis process using a computer surrogate
Grahic Jump Location
A sample set of the input head translational and rotational acceleration time histories
Grahic Jump Location
(A) Predicted peak positive and peak negative intracranial pressure-time histories; (B) Predicted intracranial pressure distribution 9 ms after the impact
Grahic Jump Location
The predicted shear stress histories in the brainstem and the thalamus regions from a typical case
Grahic Jump Location
Shear stress contours predicted by the model at 16 ms for: (A) a parasagittal section; (B) Sectional view through A-A which represents a section through the mamilothalamic tract
Grahic Jump Location
Relationship between intracranial pressure and the maximum translational acceleration (A) and between shear stress at the midbrain and the maximum rotational acceleration of the head (B)
Grahic Jump Location
Logist plots of the predicted injury probability based on shear stress at brainstem predicted by model and the input head rotational acceleration



Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In