Whiplash Injury or Concussion? A Possible Biomechanical Explanation for Concussion Symptoms in Some Individuals Following a Rear-End Collision


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Abstract

STUDY DESIGN:Finite element modeling of experimental data.BACKGROUND:The clinical presentations of whiplash injury and concussion have considerable overlap. Both diagnoses are generally based on presenting signs and symptoms, and a history of neck or head trauma. With incomplete knowledge of the trauma, differentiating between whiplash injury and concussion can be clinically challenging.OBJECTIVES:To estimate the brain strains that develop during rear-end car crashes, evaluate how these strains vary with different head kinematic parameters, and compare these strains to those generated during potentially concussive football helmet impacts.METHODS:Head kinematic data were analyzed from 2 prior studies, one that focused on head restraint impacts in rear-end crash tests and another that focused on football helmet impacts. These data were used as inputs to a finite element model of the human brain. Brain strains were calculated and compared to different peak kinematic parameters and between the 2 impact conditions.RESULTS:Brain strains correlated best with the head's angular velocity change for both impact conditions. The 4 crashes with head angular velocity changes greater than 30 rad/s (greater than 1719°/s) generated the highest brain stains. One crash, in which the head wrapped onto the top of the head restraint, generated brain strains similar to a 9.3-m/s rear football helmet impact, a level previously associated with concussion.CONCLUSION:This work provides new insight into a potential biomechanical link between whiplash injury and concussion, and advances our understanding of how head restraint interaction during a rear-end crash may cause an injury more typically associated with sports-related head impacts.

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