TY  - JOUR
PY  - 2011//
TI  - Mechanisms of primary blast-induced traumatic brain injury: Insights from shock wave research
JO  - Journal of neurotrauma
A1  - Nakagawa, Atsuhiro
A1  - Manley, Geoffrey T.
A1  - Gean, Alisa
A1  - Ohtani, Kiyonobu
A1  - Armonda, Rocco
A1  - Tsukamoto, Akira
A1  - Yamamoto, Hiroaki
A1  - Takayama, Kazuyoshi
A1  - Tominaga, Teiji
SP  - 1101
EP  - 1119
VL  - 28
IS  - 6
N2  - Traumatic brain injury caused by explosive or blast events is traditionally divided into four phases: primary, secondary, tertiary, and quaternary blast injury. These phases of blast-induced traumatic brain injury (bTBI) are biomechanically distinct and can be modeled in both in vivo and in vitro systems. The primary bTBI injury phase represents the response of brain tissue to the initial blast wave. Among the four phases of bTBI, there is a remarkable paucity of information about the cause of primary bTBI. On the other hand, 30 years of research on the medical application of shock waves (SW) has given us insight into the mechanisms of tissue and cellular damage in bTBI, including both air-mediated and underwater SW sources. From a basic physics perspective, the typical blast wave consists of a lead SW followed by supersonic flow. The resultant tissue injury includes several features observed in bTBI, such as hemorrhage, edema, pseudoaneurysm formation, vasoconstriction, and induction of apoptosis; these are well-described pathological findings within the SW literature. Acoustic impedance mismatch, penetration of tissue by shock/bubble interaction, geometry of the skull, shear stress, tensile stress and subsequent cavitation formation, are all important factors in determining the extent of SW-induced tissue and cellular injury. Herein, we describe the requirements for the adequate experimental set-up when investigating blast-induced tissue and cellular injury; review SW physics, research and the importance of engineering validation (visualization/pressure measurement/numerical simulation); and, based upon our findings of SW-induced injury, discuss the potential underlying mechanism(s) of primary bTBI.<p />  <p>Language: en</p>
LA  - en
SN  - 0897-7151
UR  - http://dx.doi.org/10.1089/neu.2010.1442
ID  - ref1
ER  -