Faculty Collaboration Database

Association of contact loading in diffuse axonal injuries from motor vehicle crashes. J Trauma 2009 Feb;66(2):309-15

Date

02/11/2009

Pubmed ID

19204502

DOI

10.1097/TA.0b013e3181692104

Scopus ID

2-s2.0-67651151298 (requires institutional sign-in at Scopus site)   55 Citations

Abstract

BACKGROUND: Although studies have been conducted to analyze brain injuries from motor vehicle crashes, the association of head contact has not been fully established. This study examined the association in occupants sustaining diffuse axonal injuries (DAIs).

METHODS: The 1997 to 2006 motor vehicle Crash Injury Research Engineering Network database was used. All crash modes and all changes in velocity were included; ejections and rollovers were excluded; injuries to front and rear seat occupants with and without restraint use were considered. DAI were coded in the database using Abbreviated Injury Scale 1990. Loss of consciousness was included and head contact was based on medical- and crash-related data.

RESULTS: Sixty-seven occupants with varying ages were coded with DAI. Forty-one adult occupants (mean, 33 years of age, 171-cm tall, 71-kg weight; 30 drivers, 11 passengers) were analyzed. Mean change in velocity was 41.2 km/h and Glasgow Coma Scale score was 4. There were 33 lateral, 6 frontal, and 2 rear crashes with 32 survivors and 9 were fatalities. Two occupants in the same crash did not sustain DAI. Although skull fractures and scalp injuries occurred in some impacts, head contact was identified in all frontal, rear, and far side, and all but one nearside crashes.

CONCLUSIONS: Using a large sample size of occupants sustaining DAI in 1991 to 2006 model year vehicles, DAI occurred more frequently in side than frontal crashes, is most commonly associated with impact load transfer, and is not always accompanied by skull fractures. The association of head contact in >95% of cases underscores the importance of evaluating crash-related variables and medical information for trauma analysis. It would be prudent to include contact loading in addition to angular kinematics in the analysis and characterization of DAI.

Author List

Yoganandan N, Gennarelli TA, Zhang J, Pintar FA, Takhounts E, Ridella SA

Authors

Frank A. Pintar PhD Chair, Professor in the Biomedical Engineering department at Medical College of Wisconsin
Narayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Accidents, Traffic
Adult
Biomechanical Phenomena
Body Mass Index
Diagnostic Imaging
Diffuse Axonal Injury
Female
Glasgow Coma Scale
Humans
Incidence
Male
Risk Factors
Wisconsin