PMID- 26539158
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20151105
LR  - 20231104
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 6
DP  - 2015
TI  - The Complexity of Biomechanics Causing Primary Blast-Induced Traumatic Brain 
      Injury: A Review of Potential Mechanisms.
PG  - 221
LID - 10.3389/fneur.2015.00221 [doi]
LID - 221
AB  - Primary blast-induced traumatic brain injury (bTBI) is a prevalent battlefield 
      injury in recent conflicts, yet biomechanical mechanisms of bTBI remain unclear. 
      Elucidating specific biomechanical mechanisms is essential to developing animal 
      models for testing candidate therapies and for improving protective equipment. 
      Three hypothetical mechanisms of primary bTBI have received the most attention. 
      Because translational and rotational head accelerations are primary contributors 
      to TBI from non-penetrating blunt force head trauma, the acceleration hypothesis 
      suggests that blast-induced head accelerations may cause bTBI. The hypothesis of 
      direct cranial transmission suggests that a pressure transient traverses the 
      skull into the brain and directly injures brain tissue. The thoracic hypothesis 
      of bTBI suggests that some combination of a pressure transient reaching the brain 
      via the thorax and a vagally mediated reflex result in bTBI. These three 
      mechanisms may not be mutually exclusive, and quantifying exposure thresholds 
      (for blasts of a given duration) is essential for determining which mechanisms 
      may be contributing for a level of blast exposure. Progress has been hindered by 
      experimental designs, which do not effectively expose animal models to a single 
      mechanism and by over-reliance on poorly validated computational models. The path 
      forward should be predictive validation of computational models by quantitative 
      confirmation with blast experiments in animal models, human cadavers, and 
      biofidelic human surrogates over a range of relevant blast magnitudes and 
      durations coupled with experimental designs, which isolate a single injury 
      mechanism.
FAU - Courtney, Amy
AU  - Courtney A
AD  - Exponent Engineering and Scientific Consulting , Philadelphia, PA , USA.
FAU - Courtney, Michael
AU  - Courtney M
AD  - BTG Research , Baton Rouge, LA , USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151019
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC4609847
OTO - NOTNLM
OT  - blast injury
OT  - blast wave transmission
OT  - thoracic mechanism
OT  - traumatic brain injury
EDAT- 2015/11/06 06:00
MHDA- 2015/11/06 06:01
PMCR- 2015/10/19
CRDT- 2015/11/06 06:00
PHST- 2014/10/02 00:00 [received]
PHST- 2015/10/05 00:00 [accepted]
PHST- 2015/11/06 06:00 [entrez]
PHST- 2015/11/06 06:00 [pubmed]
PHST- 2015/11/06 06:01 [medline]
PHST- 2015/10/19 00:00 [pmc-release]
AID - 10.3389/fneur.2015.00221 [doi]
PST - epublish
SO  - Front Neurol. 2015 Oct 19;6:221. doi: 10.3389/fneur.2015.00221. eCollection 2015.