Citation

Fievisohn E, Bailey Z, Guettler A, Vandevord P. J. Biomech. Eng. 2018; 140(2): e4038710.

Affiliation

Department of Biomedical Engineering and Mechanics, Virginia Tech, Salem Veterans Affairs Medical Center, Salam, VA, 317 Kelly Hall, 325 Stanger Street, Blacksburg, VA 24061.

Copyright

(Copyright © 2018, American Society of Mechanical Engineers)

DOI

10.1115/1.4038710

PMID

29222564

Abstract

Mild blast traumatic brain injury (bTBI) accounts for the majority of brain injury in United States service members and other military personnel worldwide. The mechanisms of primary blast brain injury continue to be disputed with little evidence to support one or a combination of theories. The main hypotheses addressed in this review are blast wave transmission through the skull orifices, direct cranial transmission, skull flexure dynamics, thoracic surge, acceleration, and cavitation. Each possible mechanism is discussed using available literature with the goal of focusing research efforts to address limitations and challenges that exist in blast injury research. It is possible that multiple mechanisms may contribute to the pathology of bTBI and could be dependent on magnitudes and orientation to blast exposure. Further focused biomechanical investigation with cadaver, in vivo, and finite element models would advance our knowledge of bTBI mechanisms. In addition, this understanding can guide future research and contribute to the greater goal of developing relevant injury criteria and mandates to protect our soldiers on the battlefield.

Language: en