Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants.
Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants.
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DOI：
10.3171/jns.2003.99.1.0143
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发表时间：
2003-07
影响因子：
4.1
通讯作者：
M. Prange;B. Coats;A. Duhaime;S. Margulies
中科院分区：
文献类型：
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作者：
M. Prange;B. Coats;A. Duhaime;S. Margulies
明显的旋转负荷条件已被证明会产生硬膜下出血和弥漫性轴索损伤。没有实验数据可用于比较婴儿头部在意外和人为头部损伤期间的旋转反应。作者试图比较自由福尔斯从不同高度跌落到不同表面时头部所承受的旋转减速，以及摇晃和撞击时头部所承受的旋转减速。方法：构建一个1.5个月大的人类婴儿的拟人替代品，并用于模拟从0.3 m（1 ft）、0.9 m（3 ft）和1.5 m（5 ft）处跌落的福尔斯，以及剧烈摇晃和头部撞击。在福尔斯跌落过程中，代理人经历了枕部接触混凝土表面、地毯垫或泡沫床垫。对于摇晃，研究人员在前后平面上反复摇晃代理人;施加的影响被定义为剧烈摇晃的终端部分，其中代理人的枕骨与刚性或衬垫表面接触。直接记录旋转速度，并计算角速度的最大（峰-峰）变化（Δ θ（max））和峰值角加速度（θ（max））。方差分析显示，与福尔斯跌落到更硬的表面和从更高的高度跌落相关的δ θ（max）和θ（max）显著增加。在对刚性表面施加冲击期间，Delta theta（max）和theta（max）显着大于在所有其他条件下测量的值。结论这个婴儿模型的剧烈摇晃产生的旋转反应类似于轻微福尔斯跌落所产生的反应，但造成的冲击产生的反应明显高于甚至1.5米跌落到混凝土上的反应。由于更大的加速度与受伤的可能性增加有关，研究结果表明，对硬表面的撞击比从低于1.5米的高度或摇晃的福尔斯更可能与惯性脑损伤有关。
OBJECT Rotational loading conditions have been shown to produce subdural hemorrhage and diffuse axonal injury. No experimental data are available with which to compare the rotational response of the head of an infant during accidental and inflicted head injuries. The authors sought to compare rotational deceleration sustained by the head among free falls, from different heights onto different surfaces, with those sustained during shaking and inflicted impact. METHODS An anthropomorphic surrogate of a 1.5-month-old human infant was constructed and used to simulate falls from 0.3 m (1 ft), 0.9 m (3 ft), and 1.5 m (5 ft), as well as vigorous shaking and inflicted head impact. During falls, the surrogate experienced occipital contact against a concrete surface, carpet pad, or foam mattress. For shakes, investigators repeatedly shook the surrogate in an anteroposterior plane; inflicted impact was defined as the terminal portion of a vigorous shake, in which the surrogate's occiput made contact with a rigid or padded surface. Rotational velocity was recorded directly and the maximum (peak-peak) change in angular velocity (delta theta(max)) and the peak angular acceleration (theta(max)) were calculated. Analysis of variance revealed significant increases in the delta theta(max) and theta(max) associated with falls onto harder surfaces and from higher heights. During inflicted impacts against rigid surfaces, the delta theta(max) and theta(max) were significantly greater than those measured under all other conditions. CONCLUSIONS Vigorous shakes of this infant model produced rotational responses similar to those resulting from minor falls, but inflicted impacts produced responses that were significantly higher than even a 1.5-m fall onto concrete. Because larger accelerations are associated with an increasing likelihood of injury, the findings indicate that inflicted impacts against hard surfaces are more likely to be associated with inertial brain injuries than falls from a height less than 1.5 m or from shaking.