Lateral Impacts Correlate with Falx Cerebri Displacement and Corpus Callosum Trauma in Sports-Related Concussions
Journal Article - Open Access
Stanford University Stanford United States
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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 impacts2 diagnosed mTBI measured with instrumented mouth guards and used finite element FE simulations to correlate falx displacement with corpus callosum deformation. Peak coronal accelerations were larger in impacts with mTBI 8592 rads2 avg. than those without 1412 rads2 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 greater than 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 genusplenium r greater than 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 percent to 17 percent. Consistent with model results, we found indications of corpus callosum trauma in diffusion tensor imaging of them TBI 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.
- Medicine and Medical Research
- Weapons Effects (Biological)