Related Experiment Video
Updated: Jun 26, 2026
07:21
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
3.1K
Simulating Cerebral Edema and Ischemia After Traumatic Acute Subdural Hematoma Using Triphasic Swelling Biomechanics
Andrew V Basilio1, Delin Zeng1, Leanne A Pichay1
1Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace MC 8904, 1210 Amsterdam Avenue, New York, NY, 10027, USA.
Annals of Biomedical Engineering
|March 27, 2024
Summary
Acute subdural hematoma (ASDH) can worsen brain swelling and ischemia, increasing intracranial pressure (ICP) and mortality. Surgical removal of convexity ASDH may reduce ICP, but its effectiveness depends on primary injury severity.
Area of Science:
- Biomechanics
- Neuroscience
- Medical Imaging
Background:
- Traumatic acute subdural hematoma (ASDH) is linked to poor outcomes due to primary and secondary brain injuries like edema and ischemia.
- The exact mechanisms driving elevated intracranial pressure (ICP) and high mortality rates in ASDH patients remain unclear.
- Cerebral edema and subsequent ICP increase are triggered by cell death and exposure of intracellular components.
Purpose of the Study:
- To investigate the role of the mass occupying effect of ASDH in exacerbating ischemic injury and elevating ICP.
- To model and simulate ASDH to predict post-traumatic brain swelling, ischemia, and ICP.
- To evaluate the impact of ASDH location and surgical intervention on ICP and patient outcomes.
Main Methods:
- Utilized FEBio software and triphasic swelling biomechanics to model clinically relevant ASDHs.
- Simulated post-traumatic brain swelling and ischemia to predict ICP.
- Analyzed the influence of convexity and interhemispheric ASDH on ICP and ischemic injury.
Main Results:
- Common convexity ASDH significantly increases ICP by worsening ischemic injury.
- Surgical removal of convexity ASDH can help manage ICP by mitigating ischemia progression.
- Interhemispheric ASDH shows minimal exacerbation of ischemia, supporting conservative management.
- In severe primary injuries, surgical intervention may be insufficient if the hematoma's contribution to ICP is minor.
Conclusions:
- The combined effects of mass occupying lesions and ischemia from ASDH contribute to elevated ICP and mortality.
- Convexity ASDH exacerbates ischemia, making surgical intervention potentially beneficial for ICP control.
- Interhemispheric ASDH has a limited impact on ischemia, justifying conservative treatment approaches.
- This modeling approach can enhance the prediction of patient outcomes following traumatic brain injuries.
Keywords:
Acute subdural hematomaCerebral edemaFinite element modelingIschemiaTraumatic brain injuryTriphasic swelling biomechanicsMore Related Videos
10:41Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound
Published on: June 3, 2021
3.6K
06:30Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
3.7K
Related Concept Videos
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:19Cerebral Edema l: Introduction
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:21Cytotoxic Edema: Pathophysiology
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...