Citation

Urban JE, Whitlow CT, Edgerton CA, Maldjian JA, Powers AK, Stitzel JD. J. Neurotrauma 2012; 29(18): 2774-2781.

Affiliation

Wake Forest University, Biomedical Engineering, Winston Salem, North Carolina, United States; jurban@wakehealth.edu.

Copyright

(Copyright © 2012, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2012.2373

PMID

22928543

Abstract

Approximately 1.7 million people sustain a traumatic brain injury (TBI) each year and Motor Vehicle Crashes (MVCs) are a leading cause for hospitalization due to TBI. Acute subdural hematoma (SDH) is a common intracranial injury that occurs in MVCs associated with high mortality and morbidity rates. In this study, SDH volume and midline shift have been analyzed in order to better understand occupant injury by correlating them to crash and occupant parameters. Fifty-seven head computed tomography scans were selected from the Crash Injury Research Engineering Network (CIREN) with Abbreviated Injury Scale (AIS) level 3+ SDH. Semi-automated methods were used to isolate the intracranial volume. SDH and additional occupant intracranial injuries were segmented across axial computed tomography (CT) images, providing a total SDH injury volume that was expressed as a percentage of total intracranial volume. SDH volume was correlated to crash parameters and occupant characteristics. Results show a positive correlation between SDH volume and crash severity in near-side and frontal crashes. Additionally, the location of the resulting hemorrhage varied by crash type. Those with greater SDH volumes had significantly lower Glasgow Coma Scale (GCS) scores at the crash site in near-side crashes. Age and fracture type were found to be significant contributors to SDH volume. This study is a volumetric analysis of real world brain injuries and known MVC impacts. The results of this study demonstrate a relationship between SDH volume, crash mechanics, and occupant characteristics that provide a better understanding of the injury mechanisms of MVC-associated TBI.

Language: en