A comparison in a youth population between those with and without a history of concussion using biomechanical reconstruction

J Neurosurg Pediatr. 2017 Apr;19(4):502-510. doi: 10.3171/2016.10.PEDS16449. Epub 2017 Jan 27.


OBJECTIVE Concussion is a common topic of research as a result of the short- and long-term effects it can have on the affected individual. Of particular interest is whether previous concussions can lead to a biomechanical susceptibility, or vulnerability, to incurring further head injuries, particularly for youth populations. The purpose of this research was to compare the impact biomechanics of a concussive event in terms of acceleration and brain strains of 2 groups of youths: those who had incurred a previous concussion and those who had not. It was hypothesized that the youths with a history of concussion would have lower-magnitude biomechanical impact measures than those who had never suffered a previous concussion. METHODS Youths who had suffered a concussion were recruited from emergency departments across Canada. This pool of patients was then separated into 2 categories based on their history of concussion: those who had incurred 1 or more previous concussions, and those who had never suffered a concussion. The impact event that resulted in the brain injury was reconstructed biomechanically using computational, physical, and finite element modeling techniques. The output of the events was measured in biomechanical parameters such as energy, force, acceleration, and brain tissue strain to determine if those patients who had a previous concussion sustained a brain injury at lower magnitudes than those who had no previously reported concussion. RESULTS The results demonstrated that there was no biomechanical variable that could distinguish between the concussion groups with a history of concussion versus no history of concussion. CONCLUSIONS The results suggest that there is no measureable biomechanical vulnerability to head impact related to a history of concussions in this youth population. This may be a reflection of the long time between the previous concussion and the one reconstructed in the laboratory, where such a long period has been associated with recovery from injury.

Keywords: CFC = channel frequency class; CSDM = cumulative strain damage measure; MADYMO = mathematical dynamic model; PCS = persistent concussive syndrome; PERC = Pediatric Emergency Research Canada; TBI = traumatic brain injury; UCDBTM = University College of Dublin Brain Trauma Model; VN = vinyl nitrile; biomechanics; concussion; history; trauma; youth.

MeSH terms

  • Adolescent
  • Biomechanical Phenomena / physiology*
  • Brain Concussion / epidemiology*
  • Brain Concussion / physiopathology*
  • Canada
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Male
  • Time Factors