Biomechanics of Pediatric Head Injury

小儿头部损伤的生物力学

• 批准号: 6726021
• 负责人: Susan Sheps Margulies
• 金额: $ 49.05万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-05-15 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6726021
• 关键词: age difference; bioengineering /biomedical engineering; biological models; biomechanics; brain injury; clinical research; computer simulation; diagnosis design /evaluation; disease /disorder etiology; disease /disorder prevention /control; growth /development; head /neck injury; human data; human tissue; immunocytochemistry; mathematical model; model design /development; neuroanatomy; newborn animals; pathologic process; pediatrics; physical property; skull; statistics /biometry; swine; weanling animal

Head injury is a leading cause of death and acquired disability in childhood. However, the biomechanics of pediatric head injury are poorly understood, primarily due to, the paucity of age-specific data regarding mechanical properties of immature tissue and its response to specific loads. The interdisciplinary proposed research plan is designed to answer the following question: What mechanisms cause what injuries in children of what age? The long-term objectives of the proposed research plan are to determine mechanical properties of the skull and brain, the loads they can withstand safely, and unique mechanisms for primary brain injury in infants (less than 3 months) and young children (1-3 years). In so doing, the long term impact of proposed research plan will be to open pathways for enhanced traumatic head injury prevention, detection, and treatment strategies specific to infants and toddlers. Both contact and non-contact mechanisms of brain injury will be investigated. The research plan uses an integrated bioengineering approach consisting of animal experiments, human and animal tissue tests, clinical studies, and anthropomorphic surrogates, all complemented by mathematical models to: A) measure pediatric tissue injury thresholds for acute neural, vascular, and blood-brain barrier damage B) measure pediatric skull and brain tissue mechanical properties C) create computational models for infant and toddler head injury using (A) and (B) D) qualitatively validate the computational model predictions with witnessed accidental head injuries in children E) measure loads experienced anthropomorphic surrogates during falls, shakes, and inflicted impacts F) determine the relative roles of impact forces and inertial loads in the etiology of primary brain injuries G) compare the computational simulations with acute clinical data to infer potential mechanisms of injury in non-accidental head injury. The overall hypotheses of the proposed research program are that 1) thresholds for skull fracture and tissue injury and mechanical properties of the brain and skull vary with age, such that both contribute to differences in primary head injuries between infants and toddlers, and 2) the increased compliance of the infant skull results in greater brain tissue injury from impact trauma; and 3) a valid computational model can be created to predict specific primary injuries resulting from a given reported mechanism.

头部损伤是儿童死亡和获得性残疾的主要原因。然而，儿童头部损伤的生物力学知之甚少，主要是由于缺乏关于未成熟组织力学特性及其对特定负荷反应的年龄特异性数据。提出的跨学科研究计划旨在回答以下问题：什么机制在什么年龄的儿童中造成什么伤害？拟议研究计划的长期目标是确定颅骨和大脑的力学特性，它们可以安全承受的载荷，以及婴儿（不到3个月）和幼儿（1-3岁）原发性脑损伤的独特机制。在这样做的过程中，拟议研究计划的长期影响将是为加强针对婴幼儿的创伤性头部损伤预防、检测和治疗策略开辟途径。将研究接触性和非接触性脑损伤机制。该研究计划采用综合生物工程方法，包括动物实验、人体和动物组织测试、临床研究和拟人化代理，所有这些都辅以数学模型，以便：A)测量急性神经、血管和血脑屏障损伤的儿童组织损伤阈值B)测量儿童颅骨和脑组织力学特性C)使用（A)和(B)创建婴幼儿头部损伤的计算模型D）定性地验证计算模型预测的儿童意外头部损伤E)测量在跌倒、摇晃、F)确定冲击力和惯性载荷在原发性脑损伤病因学中的相对作用G)将计算模拟与急性临床数据进行比较，以推断非意外性脑损伤的潜在损伤机制。提出的研究计划的总体假设是：1)颅骨骨折和组织损伤的阈值以及大脑和颅骨的力学特性随年龄的变化而变化，这两者都导致了婴儿和幼儿原发性头部损伤的差异；2)婴儿颅骨顺应性的增加导致了更大的冲击创伤脑组织损伤；3)可以建立一个有效的计算模型来预测由给定的报道机制引起的特定原发性损伤。