Progress in the mechanism and protection of blast-induced traumatic brain injury

被引：0
作者：
Liu Z. [1 ]
Du Z. [1 ]
Zhang J. [1 ]
Yan Z. [1 ]
Li Z. [1 ]
Wang P. [1 ]
Kang Y. [2 ]
Huang X. [2 ]
Ma T. [2 ]
Fei Z. [3 ]
Zhuang Z. [1 ]
机构：
[1] School of Aerospace Engineering, Tsinghua University, Beijing
[2] Institute of Quartermaster Engineering and Technology, Academy of Military Sciences, Beijing
[3] Xijing Hospital, Air Force Military Medical University, Xi'an
来源：
Baozha Yu Chongji/Explosion and Shock Waves | 2022年 / 42卷 / 04期
关键词：
Evaluation index; Injury mechanism; Post-traumatic stress disorder; Protection structure design; Traumatic brain injury;
D O I：
10.11883/bzycj-2021-0053
中图分类号：
学科分类号：
摘要：
Blast-induced traumatic brain injury (bTBI) is one of the major injuries sustained by soldiers in armed conflict, which has been widely concerned by domestic and overseas researchers in recent years. The brain injury caused by a direct interaction between the blast wave and the head is called primary bTBI. Currently, the injury mechanism of primary bTBI is still unclear. The primary bTBI may be the combined result of multi-factors, such as stress wave propagation, skull flexural deformation, cerebrospinal fluid cavitation, and trunk compression. Since it is a complex problem involving the interdisciplinary of medical and engineering, multi-physical field coupling, and coexistence of short-term and long-term effects, it is necessary to reveal the injury mechanism of bTBI by combining physical experiments, numerical simulations, and medical diagnosis. There are three strategies to investigate bTBI. One is to establish a high-precision and multi-physical-field numerical model to describe the interaction of the blast wave and the head. The second is to develop a surrogate head model to measure the skull strain, intracranial pressure, acceleration, and other mechanical quantities. The third is to analyze human and animal pathology and physiology. Comparing the results of these three strategies can reveal the injury mechanism of bTBI in medicine and mechanics. The research status and development in this field are introduced in this paper based on the authors' previous research. The evaluation indexes of bTBI are summarized, including the medical indexes related to behavior and physiology and the critical mechanical indexes, such as skull strain, intracranial pressure, and local stress. Furthermore, the protective structure design based on the injury mechanism and the evaluation indexes is described, including the improvement of the helmet system based on new materials, the design of the helmet buffer system, the increase of the sealing of the head protection system, etc. To figure out the bTBI mechanism, more accurate measurement of the in-situ mechanical properties of the brain tissue, and high fidelity numerical and physical models are needed. For bTBI protection research, it needs to improve the biological matching degree and the accuracy of the experimental platform. Finally, three development trends of the bTBI research are pointed out, including the development of multi-scale head models, accurate measurement and verification of the injury indexes and threshold, comprehensive investigation of injury mechanism, evaluation, and protection. © 2022, Editorial Staff of EXPLOSION AND SHOCK WAVES. All right reserved.
引用
收藏
相关论文
共 81 条
  • [1] MAAS A I R, MENON D K, ADELSON P D, Et al., Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research, The Lancet Neurology, 16, 12, pp. 987-1048, (2017)
  • [2] PHIPPS H, MONDELLO S, WILSON A, Et al., Characteristics and impact of U. S. military blast-related mild traumatic brain injury: a systematic review, Frontiers in Neurology, 11, (2020)
  • [3] TANIELIAN T, HAYCOX L H, SCHELL T L, Et al., Invisible wounds of war. summary and recommendations for addressing psychological and cognitive injuries: ADA480992, (2008)
  • [4] (2019)
  • [5] MOORE D F, RADOVITZKY R A, SHUPENKO L, Et al., Blast physics and central nervous system injury, Future Neurology, 3, 3, pp. 243-250, (2008)
  • [6] MILLER T C, ZWERDLING D., Brain injuries remain undiagnosed in thousands of soldiers [DB/OL]
  • [7] KOBEISSY F H., Brain neurotrauma: molecular, neuropsychological, and rehabilitation aspects, (2015)
  • [8] TEASDALE G, JENNETT B., Assessment and prognosis of coma after head injury, Acta Neurochirurgica, 34, 1, pp. 45-55, (1976)
  • [9] DAL CENGIO LEONARDI A, BIR C A, RITZEL D V, Et al., Intracranial pressure increases during exposure to a shock wave, Journal of Neurotrauma, 28, 1, pp. 85-94, (2011)
  • [10] DAL CENGIO LEONARDI A, KEANE N J, BIR C A, Et al., Head orientation affects the intracranial pressure response resulting from shock wave loading in the rat, Journal of Biomechanics, 45, 15, pp. 2595-2602, (2012)
123456789