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Biomech Model Mechanobiol. 2019 Jun;18(3):631-649. doi: 10.1007/s10237-018-01106-0. Epub 2019 Mar 12.

Lateral impacts correlate with falx cerebri displacement and corpus callosum trauma in sports-related concussions.

Author information

1
Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA.
2
Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA.
3
Department of Radiology, Stanford University, Stanford, CA, 94305, USA.
4
Department of Neurosurgery, Stanford University, Stanford, CA, 94305, USA.
5
Department of Neurology, Stanford University, Stanford, CA, 94305, USA.
6
Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA. dcamarillo@stanford.edu.
7
Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA. dcamarillo@stanford.edu.

Abstract

Corpus callosum trauma has long been implicated in mild traumatic brain injury (mTBI), yet the mechanism by which forces penetrate this structure is unknown. We investigated the hypothesis that coronal and horizontal rotations produce motion of the falx cerebri that damages the corpus callosum. We analyzed previously published head kinematics of 115 sports impacts (2 diagnosed mTBI) measured with instrumented mouthguards and used finite element (FE) simulations to correlate falx displacement with corpus callosum deformation. Peak coronal accelerations were larger in impacts with mTBI (8592 rad/s2 avg.) than those without (1412 rad/s2 avg.). From FE simulations, coronal acceleration was strongly correlated with deep lateral motion of the falx center (r = 0.85), while horizontal acceleration was correlated with deep lateral motion of the falx periphery (r > 0.78). Larger lateral displacement at the falx center and periphery was correlated with higher tract-oriented strains in the corpus callosum body (r = 0.91) and genu/splenium (r > 0.72), respectively. The relationship between the corpus callosum and falx was unique: removing the falx from the FE model halved peak strains in the corpus callosum from 35% to 17%. Consistent with model results, we found indications of corpus callosum trauma in diffusion tensor imaging of the mTBI athletes. For a measured alteration of consciousness, depressed fractional anisotropy and increased mean diffusivity indicated possible damage to the mid-posterior corpus callosum. Our results suggest that the corpus callosum may be sensitive to coronal and horizontal rotations because they drive lateral motion of a relatively stiff membrane, the falx, in the direction of commissural fibers below.

KEYWORDS:

Corpus callosum trauma; Finite element method; Instrumented mouthguard; Mild traumatic brain injury

PMID:
30859404
DOI:
10.1007/s10237-018-01106-0

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