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Primary Blast Brain Injury Mechanisms: Current Knowledge, Limitations, and Future Directions
Elizabeth Fievisohn1, Zachary Bailey2, Allison Guettler3
1Department of Biomedical Engineering and Mechanics, Virginia Tech, 440 Kelly Hall, 325 Stanger Street, Blacksburg, VA 24061 e-mail: .
Journal of Biomechanical Engineering
|December 10, 2017
Summary
Understanding mild blast traumatic brain injury (bTBI) mechanisms is crucial for military personnel. This review examines blast wave transmission, cranial impact, and other theories to guide future research and soldier protection.
Area of Science:
- Neurology
- Biomechanics
- Military Medicine
Background:
- Mild blast traumatic brain injury (bTBI) is a significant concern for military personnel.
- Current understanding of primary bTBI mechanisms lacks definitive evidence, with several competing hypotheses.
- Existing research faces limitations and challenges in accurately modeling blast injury.
Purpose of the Study:
- To review and discuss the primary proposed mechanisms of blast-induced traumatic brain injury.
- To identify limitations and challenges in current blast injury research.
- To guide future research efforts toward understanding bTBI pathology and developing protective measures.
Main Methods:
- Literature review of existing hypotheses on bTBI mechanisms.
- Discussion of blast wave transmission, cranial impact, thoracic surge, acceleration, and cavitation.
- Analysis of cadaver, in vivo, and finite element modeling approaches.
Main Results:
- Multiple mechanisms, including blast wave transmission through orifices, direct cranial impact, skull flexure, thoracic surge, acceleration, and cavitation, are considered.
- The contribution of each mechanism may depend on blast magnitude and orientation.
- Current evidence is insufficient to definitively support a single or combined theory.
Conclusions:
- Further focused biomechanical investigations are essential to advance bTBI mechanism knowledge.
- Understanding bTBI mechanisms can inform the development of injury criteria and protective mandates for soldiers.
- Collaborative research is needed to address the complexities of blast-induced brain injuries.
