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A Biomechanical Analysis of the Causes of Traumatic Brain Injury in Infants and Children

Goldsmith, Werner PhD*; Plunkett, John MD

The American Journal of Forensic Medicine and Pathology: June 2004 - Volume 25 - Issue 2 - p 89-100
doi: 10.1097/01.paf.0000127407.28071.63
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There is significant disagreement among medical professionals regarding the mechanisms for infant brain injury. This disagreement is due in part to the failure by some to acknowledge and incorporate known biomechanical data and models into hypotheses regarding causes. A proper biomechanical understanding of the mechanisms of traumatic brain injury (TBI) challenges many published and testified assumptions regarding TBI in infants and children.

This paper analyzes the biomechanical relationship between the causes of TBI in infants and children, and their physiological consequences. Loading characteristics, injury parameters and criteria, scaling, failure characteristics, differences between infants and adults, and impact due to falls are described and discussed in the context of the laws of mechanics. Recent studies are critiqued with reference to their contribution to an understanding of brain injury mechanisms. Finally, methods for improving our currently incomplete knowledge of infant head injuries, and their mechanisms, consequences and tolerances are proposed. There is an urgent need for close collaboration between physicians and biomechanicians to objectively and scientifically evaluate infant head injuries to further define their mechanical bases, and to assist in their diagnosis and treatment.

From the *Graduate School, Departments of Mechanical Engineering and Bioengineering, University of California, Berkeley, California; and the †Department of Laboratory and Medical Education, Regina Medical Center, Hastings, Minnesota.

Reprints: John Plunkett, MD, Laboratory and Medical Education Director, Regina Medical Center, 1175 Nininger Road, Hastings, MN 55033. E-mail: plunkettj@reginamedical.org.

© 2004 Lippincott Williams & Wilkins, Inc.