This thesis investigates head injuries (HIs) occurring in sports and recreation (SR) that presented to emergency departments (EDs) in Edmonton, Alberta, from April 1st, 1997 to March 31st, 2008. There were 4,950 SR HIs identified over the 11 years (5.13 HIs per 1,000 ED injury visits). Individuals less than 18 years old were 3.4 times more likely, and males were 1.25 times more likely to present with a head injury from SR (p < 0.0001). A history of one or two previous SR HIs increased the odds of subsequent HI by 2.62 and 5.94 times, respectively, while children aged 7 13 and 14 17 were more than four times more likely to sustain a HIs from SR (p < 0.001). The effects of multiple HIs occurring in children participating in SR activities needs to be addressed, due to the chronic neurobehavioral effects of HIs. / Epidemiology

Disputats, Umeå universitet, 2006. / Härtill 3 uppsatser.

Orientador: Cecilia Amélia de Carvalho Zavaglia / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica / Made available in DSpace on 2018-08-26T13:44:25Z (GMT). No. of bitstreams: 1 Saura_CarlosEduardo_D.pdf: 6545554 bytes, checksum: 6e172e4f392006d2c809c0f86185aff1 (MD5) Previous issue date: 2014 / Resumo: Esta tese demonstra os benefícios relacionados ao uso efetivo de uma metodologia que visa guiar todo processo de cranioplastia, utilizando-se de implantes personalizados para regenerar falhas cranianas. Sabe-se que diferentes técnicas de implante, geralmente atreladas a casos médicos específicos, têm sido aplicadas já há vários anos. Isso acarretou uma grande e valiosa evolução nesta área, porem também gerou dúvidas sobre qual técnica seria a mais eficaz a ser empregada em cada caso. A metodologia aqui explanada visa auxiliar desde o diagnóstico, passando pela coleta de imagens médicas, elaboração do modelo tridimensional do paciente contendo sua falha óssea, modelamento do implante, criação física do mesmo através do uso da Manufatura Aditiva (MA) e finalmente a aplicação do implante no paciente. Esta metodologia é aplicável aos implantes personalizados metálicos, poliméricos ou cerâmicos, e direcionados para serem executados pela tecnologia de MA que também é conhecida como prototipagem rápida. Na origem do processo está a captura de imagens médicas do crânio e da falha óssea através de tomografia computadorizada. As fatias tomográficas são transformadas em um modelo tridimensional no sistema InVesalius® (CTI ¿ Brasil) e os arquivos neles criados são transferidos para um programa específico utilizado na MA chamado Magics RP ¿, nele então o biomodelo tridimensional é analisado e preparado para execução de um modelo físico. Na criação do implante em caso de falhas pequenas ou médias que estão alocadas totalmente em um dos hemisférios do crânio pode-se usar apenas o Magics RP ¿. Em casos de falhas grandes laterais (que invadem o hemisfério oposto) ou frontais, utiliza-se o programa de CAD, neste caso o SolidWorks ¿, no qual são trabalhadas superfícies e sólidos com o objetivo de reconstruir fielmente o perfil craniano através do implante que está sendo desenvolvido. Os resultados obtidos com o uso da metodologia são implantes de adequação perfeita, diminuição no tempo de cirurgia e rápida recuperação e integração social do paciente. Conclui-se que o grande benefício de se ter uma Metodologia para Desenvolvimento de Implantes Cranianos Personalizados é que esta orienta através de um conjunto de diretrizes as equipes multidisciplinares compostas de cirurgiões, radiologistas, técnicos e engenheiros, estejam orientadas e preparadas a atender a crescente necessidade de implantes cranianos personalizados / Abstract: This thesis demonstrates the benefits related to the effective use of a methodology that aims to guide the whole process of cranioplasty, using custom implants to regenerate cranial defects. Known is that different implant techniques, usually linked to specific medical cases, has being applied for several years. This led to large and valuable developments in this area, but also raised questions about which one would be the most effective technique employed in each case. The methodology here explained aims to give an assistance from diagnosis, through the collection of medical imaging, three-dimensional model of patient preparation containing your bone gap, modeling of the implant, creating physically the implant with the Additive Manufacturing (MA) and finally the application of implant into the patient. This methodology is applicable to custom metallic implants, polymeric or ceramic and produced with MA technology, which is also known as rapid prototyping. The process is capturing medical images of skull and bone gap through computerized tomography. Tomographic slices are transformed into a three-dimensional model in InVesalius ® system (CTI-Brazil) and the files in them created are transferred to a specific program used in MA, called Magics RP ¿, it then the three-dimensional biomodelo is parsed and prepared for execution of a physical model. In the creation of the implant in case of small or medium failures allocated fully in one of the skull hemisphere can only use the Magics RP ¿. In cases of large lateral faults (invading the opposite hemisphere) or front, we use CAD program, in this case the SolidWorks ¿, in which we work with surfaces and solids in order to be faithfully reconstruct cranial profile through the implant is being developed. The results obtained with the use of the methodology are perfect adequacy implants, decreased at the time of surgery and speedy recovery and social integration of the patient. Concluded is that the major benefit of having a methodology for developing Custom Cranial Implants is that this leads you through a set of guidelines the multidisciplinary teams composed of surgeons, radiologists, technicians and engineers, are targeted and prepared to meet the growing need for custom cranial implants / Doutorado / Materiais e Processos de Fabricação / Doutor em Engenharia Mecânica

Thesis (M.A.(Clinical Psychology)) -- University of Limpopo, 2015. / The effect of Cumulative Mild Head Injury (CMHI) in contact sports, such as rugby, is seen increasingly at school level where more and more injuries are reported. Research on CMHI in contact sport is needed specifically amongst previously disadvantaged groups where little or no research has taken place. The research is thus intended to seek a better understanding of CMHI in the contact sport of rugby specifically amongst amateur players. A quantitative research approach was utilised with a quasi-experimental research design. A sample of 18 student rugby players and 18 volleyball (non-contact sport) controls was used. In terms of mean performances the tests did not reveal a consistent pattern of deficits which is typically associated with the effects of Cumulative Mild Head Injuries. There were significant results however, in terms of variability that suggests potential deficits in attention among the rugby group. The results are therefore indicative of a poorer overall cognitive profile for the rugby playing group. It is concluded that the increased variability may be displayed in individuals who suffer CMHI at an earlier age.

Background: Cerebrovascular injury (CVI) is a potentially devastating complication of gunshot wounds to the head (GSWH), with yet unclear incidence and prognostic implications. Few studies have also attempted to define CVI risk factors and their role in patient outcomes. We aimed to describe 10 years of CVI from GSWH and characterize these injury patterns. Methods: Single-institution data from 2009 to 2019 were queried to identify patients presenting with dural-penetrating GSWH. Patient records were reviewed for GSWH characteristics, CVI patterns, management, and follow-up. Results: Overall, 63 of 297 patients with GSWH underwent computed tomography angiography (CTA) with 44.4% showing CVI. The middle cerebral artery (22.2%), dural venous sinuses (15.9%), and internal carotid artery (14.3%) were most frequently injured. Arterial occlusion was the most prominent injury type (22.2%) followed by sinus thrombosis (15.9%). One fifth of patients underwent delayed repeat CTA, with 20.1% showing new/previously unrecognized CVI. Bihemispheric bullet tracts were associated with CVI occurrence (P = 0.001) and mortality (P = 0.034). Dissection injuries (P = 0.013), injuries to the vertebrobasilar system (P = 0.036), or the presence of ≥2 concurrent CVIs (P = 0.024) were associated with increased risk of mortality. Of patients with CVI on initial CTA, 30% died within the first 24 hours. Conclusions: CVI was found in 44.4% of patients who underwent CTA. Dissection and vertebrobasilar injuries are associated with the highest mortality. CTA should be considered in any potentially survivable GSWH. Longitudinal study with consistent CTA use is necessary to determine the true prevalence of CVI and optimize the use of imaging modalities.

This quantitative research is on the efficacy of Minnesota Statute 144.574 enacted in 2005 in response to the growing awareness of behavior leading to inflicted Traumatic Brain Injuries (iTBI) in infants and children. The model for this research is grounded in the Theory of Reasoned Action wherein the education of new parents which graphically explains the physiologic changes to the structural architecture of the brain post-trauma, paired with their signature on a social contract (SC), demonstrated a reduction in incidence. Because the enacted statute does not include the signing of a SC, nor does it require face-to-face education as in the model, Statute 144.574 cannot claim to be completely grounded in medical science. The result is that neither legislators nor the medical and public health community know whether the statute is effective in lowering incidence. This research was designed to explore the difference in the incidence pre-and post-enactment, in rural vs. urban communities, the proportion of incidence and ethnicity, and an ordinal shift in the distribution of severity. All births in Minnesota from 1998 through 2017 were included. Cases defined using International Classification of Disease were extracted from secondary data from the brain and spinal cord injury, hospital discharge, and vital statistics databases. A Z-test was employed to compare the incidence in a control cohort of infants and children born prior to enactment to the incidence of same in an interventional cohort born post-enactment. Results suggest the statute has not resulted in lowering incidence, have uncovered an unanticipated statistically significant increase in rural vs. urban incidence, yet point to a trend in favor of less severe iTBI. These results represent a positive social change which is grounded in the society's imperative and social justice of protecting children by informing public health officials, caregivers, and legislators of the need for meaningful reform and strengthening of programs leading to lowering the incidence of iTBI in children in Minnesota.

Background: Cerebrovascular injury (CVI) is a potentially devastating complication of gunshot wounds to the head (GSWH), with yet unclear incidence and prognostic implications. Few studies have also attempted to define CVI risk factors and their role in patient outcomes. We aimed to describe 10 years of CVI from GSWH and characterize these injury patterns. Methods: Single-institution data from 2009 to 2019 were queried to identify patients presenting with dural-penetrating GSWH. Patient records were reviewed for GSWH characteristics, CVI patterns, management, and follow-up. Results: Overall, 63 of 297 patients with GSWH underwent computed tomography angiography (CTA) with 44.4% showing CVI. The middle cerebral artery (22.2%), dural venous sinuses (15.9%), and internal carotid artery (14.3%) were most frequently injured. Arterial occlusion was the most prominent injury type (22.2%) followed by sinus thrombosis (15.9%). One fifth of patients underwent delayed repeat CTA, with 20.1% showing new/previously unrecognized CVI. Bihemispheric bullet tracts were associated with CVI occurrence (P = 0.001) and mortality (P = 0.034). Dissection injuries (P = 0.013), injuries to the vertebrobasilar system (P = 0.036), or the presence of ≥2 concurrent CVIs (P = 0.024) were associated with increased risk of mortality. Of patients with CVI on initial CTA, 30% died within the first 24 hours. Conclusions: CVI was found in 44.4% of patients who underwent CTA. Dissection and vertebrobasilar injuries are associated with the highest mortality. CTA should be considered in any potentially survivable GSWH. Longitudinal study with consistent CTA use is necessary to determine the true prevalence of CVI and optimize the use of imaging modalities.

Yes / The paper presents a multidisciplinary design optimisation strategy for car front-end profile to minimise head injury criteria across pedestrian groups. A hybrid modelling strategy was used to simulate the car-pedestrian impact events, combining parametric modelling of front-car geometry with pedestrian models for the kinematics of crash impact. A space filling response surface modelling strategy was deployed to study the head injury response, with Optimal Latin Hypercube (OLH) Design of Experiments sampling and Kriging technique to fit response models. The study argues that the optimisation of the front-end car geometry for each of the individual pedestrian models, using evolutionary optimisation algorithms is not an effective global optimization strategy as the solutions are not acceptable for other pedestrian groups. Collaborative Optimisation (CO) multidisciplinary design optimisation architecture is introduced instead as a global optimisation strategy, and proven that it can enable simultaneous minimisation of head injury levels for all the pedestrian groups, delivering a global optimum solution which meets the safety requirements across the pedestrian groups.

Subconcussive impacts have become a growing concern particularly with respect to contact sports. It is believed that minimal head impacts can cause cerebral perturbations that initiate an immune response creating a window of vulnerability. Evidence suggests that additional head insults sustained during this window of vulnerability elicit an exaggerated inflammatory response and exacerbate cognitive deficits. Therefore, determining the lower limits of systematic perturbation resulting from low-level impacts is of critical importance in expanding our understanding of cerebral vulnerability and recovery. However, the vast majority of experimental investigations of subconcussion fail to model single impact events and instead focus on cumulative insults. Additionally, these animal models employ impact magnitudes used to model mild Traumatic Brain Injury. The present investigation aimed to address this gap in knowledge through the utilization of a pneumatically controlled, closed-head, blunt impact device capable of producing repeatable, defined, subconcussive head impacts within a rat model. Thermography was used as a noninvasive measure of inflammation and system perturbations with respect to local (head) and global (thorax and abdomen) temperature changes. Cognitive function was assessed using an Open Field Test and Novel Object Recognition test. Neuroinflammation was measured by assessment of GFAP and iba-1 within the hippocampus and corpus callosum. To investigate the tolerance and the persistence of cerebral vulnerability, measurement outcomes were assessed at six timepoints of recovery, 0, 0.5, 1, 4, 7, and 14 days. Thermal disturbances were detected directly after impact, followed by an apparent recovery, 0.5- and 1-day post-impact. A latent temperature increase was observed after 4- and 7-days of recovery coinciding with decreased risk-avoidance behaviors, a modest upregulation of iba-1, and a marked downregulation of GFAP. Short-term memory deficits became apparent after 7-days of recovery. A decrease in locomotor activity and an upregulation of GFAP was observed concomitant to a persistent decrease in risk-avoidance despite thermal, short-term memory, and iba-1 measurements recovery 14-days post-impact. Overall, these results indicate that low magnitude subconcussive impacts can produce latent thermal, behavioral, and histological disturbances uncharacteristic for a head injury model suggestive of a biomechanical threshold of altered pathodynamics that fail to fully recover after 14 days.

A biofidelic finite element model was developed from an acquired set of CT scans for a range of human head and UAS impacts to provide simulations of multiple velocity scenarios of impact severity at four impact orientations on the human head. The hypothesis was that a correlation existed between the total amounts of kinetic energy of the impact from the UAS and human head collision, as well as that location of impact plays a role in the injury risk sustained. Linear acceleration, angular velocity, and pressure data values were calculated for each individual simulated case and then further correlated to injury risks that represent the severity of damage that would be sustained from the collision. Resulting data proved to show that impact kinetic energy, impact orientation, and impact response of the head and UAS all play vital roles in the amount of damage that is sustained from the impact collisions.