Citation

Viano DC, Hamberger A, Bolouri H, Saljo A. Neurosurgery 2009; 64(6): 1162-73; discussion 1173.

Affiliation

Mild Traumatic Brain Injury Committee, National Football League, New York, New York, USA. dviano@comcast.net

Copyright

(Copyright © 2009, Congress of Neurological Surgeons)

DOI

10.1227/01.NEU.0000345863.99099.C7

PMID

19487897

Abstract

OBJECTIVE: A concussion model was developed to study injury mechanisms, functional effects, treatment, and recovery. Concussions in National Football League American football involve high-impact velocity (7.4-11.2 m/s) and rapid change in head velocity (DeltaV) (5.4-9.0 m/s). Current animal models do not simulate these head impact conditions. METHODS: One hundred eight adult male Wistar rats weighing 280 to 350 g were used in ballistic impacts simulating 3 collision severities causing National Football League-type concussion. Pneumatic pressure accelerated a 50 g impactor to velocities of 7.4, 9.3, and 11.2 m/s at the left side of the helmet-protected head. A thin layer of padding on the helmet controlled head acceleration, which was measured on the opposite side of the head, in line with the impact. Peak head acceleration, DeltaV, impact duration, and energy transfer were determined. Fifty-four animals were exposed to single impact, with 18 each having 1, 4, or 10 days of survival. Similar tests were conducted on another 54 animals, which received 3 impacts at 6-hour intervals. An additional 72 animals were tested with a 100g impactor to study more serious brain injuries. Brains were perfused, and surface injuries were identified. RESULTS: The 50 g impactor matches concussion conditions scaled to the rat. Impact velocity and head DeltaV were within 1% and 3% of targets on average. Head acceleration reached 450 g to 1750 g without skull fracture. The test is repeatable and robust. Gross pathology was observed in 11%, 28%, and 33% of animals in the 7.4-, 9.3-, and 11.2-m/s single impacts, respectively. At 7.4 m/s, a single diameter area of less than 0.5 mm of fine petechial hemorrhage occurred on the brain surface in the parenchyma and meninges nearest the point of impact. At higher velocities, there were larger areas of bleeding, sometimes with subdural hemorrhage. When the 50 g impactor tests were examined by logistic regression, greater energy transfer increased the probability of injury (odds ratio, 5.83; P = 0.01), as did 3 repeat impacts (odds ratio, 4.72; P = 0.002). The number of survival days decreased the probability of observing injury (odds ratio, 0.25 and 0.11 for 4 and 10 days, respectively, compared with 1 day). The 100g impactor produced more severe brain injuries. CONCLUSION: A concussion model was developed to simulate the high velocity of impact and rapid head DeltaV of concussions in National Football League players. The new procedure can be used to evaluate immediate and latent effects of concussion and more severe injury with greater impact mass.

Language: en