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Clinical Biomechanics of Penetrating Brain Injury
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III) Clinical Biomechanics of Penetrating Brain Injury
Title:
Clinical Biomechanics of Penetrating Brain Injury
Project Director:
Thomas Gennarelli, MD
Project Co-director:
Frank Pintar, PhD
Institutions:
Medical College of Wisconsin, Medical College of Wisconsin Biomechanics Laboratory, Zablocki VA Medical Center, Froedtert Memorial Lutheran Hospital
Categorization I:
Acute Care
Categorization II:
Major Project
Categorization III:
New
Cost / Year:
$100,000 / year
Duration:
Five Years
Key Words:
penetrating head injury, TBI, head injury, brain injury, cranium, gunshot wounds, computer finite element models
Abstract:
Long term Objectives and Specific Aims:
As treatment methods of penetrating wounds to the head became more advanced and duration of time to treatment became shorter, these wounds warrant further study. Aspects to the survivability of gunshot wounds to the cranium include the type of weapon, projectile and the location of trauma. The physical simulant models have the advantage of direct filming of high-speed projectiles using the latest high-speed digital videography (18,000-40,000 f/s). The approach in this grant is two-fold: to better understand survivability, a series of physical models and computer finite element models that will characterize and quantify the mechanics associated with wounding energy will be created. High-velocity projectiles through the brain impart tremendous pressures within the tissues, inducing strains that may or may not produce permanent damage to the structures. The pressures in and immediately around the wounding track are known to cause damage. The potential for a larger wounded area due to secondary pressures has not been thoroughly examined. The specific hypothesis is that the penetrating traumatic brain injury wound energy is directly related to the magnitude of pressure wave distributions within the cranial vault that occurs during the traumatic event and that additional wounded areas may occur if the secondary pressures reach damaging magnitudes. The specific objectives are linked to both short-term and long-term patient outcome. For the short-term, the principal issues are the determinants of initial survivability. It is anticipated that these determinants will include the wounding energy and missile trajectory.
Research Design and Methods:
Computer models of these variables that predict not only initial survivability, but also specific areas where the brain is damaged will be developed. Patients who survive penetrating traumatic brain injury often require treatment for various combinations of motor, sensory, cognitive or behavioral impairments. Using advanced imaging techniques; tools for visualizing the patient-specific tissue damage to assist the clinician in the continued treatment of these patients will be developed.
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