Each year, approximately 1,300 children in the U.S. are victims of severe or fatal head trauma from child abuse such as shaken baby syndrome, according to the National Institutes of Health. For many, the diagnosis comes too late — a child can go to a hospital several times before a doctor realizes the infant was a victim of abuse.
University of Utah Mechanical Engineering Assistant Professor Brittany Coats and her research team believe there is a better way to detect traumatic brain injuries (TBI). They are researching small structures in the “subarachnoid space,” a thin layer between the skull and brain, to determine if they can be used as early indicators of head trauma.
This layer, about two to three millimeters thick, contains web-like structures called arachnoid trabeculae that tether the brain to the skull and help protect it during severe head rotations. Most devastating traumatic brain injuries are the result of head rotation as opposed to an impact to the skull, Coats said. If the brain rotates too much, these structures can get damaged, which could make the brain more vulnerable to future injury.
“Think of your brain as a bowl of Jello. If I rotate the Jello really fast, the outer edges have much larger deformations than the center,” said Coats, who specializes in biomechanics, the study of how forces are applied to the human body. “This causes shearing within the brain and can result in diffuse traumatic brain injury which substantially affects your functional and cognitive capabilities.”
But little research has been done on this subarachnoid layer. So Coats examined the arachnoid trabeculae using optical coherence tomography, the same imaging technology used to probing the eye. From this information, she created a computational 3D model of the space and simulated a head rotation to determine how the arachnoid trabeculae influence the mechanics of the brain, which can be used to predict TBI. The result is a method that is much more sensitive and a better predictor of mild TBI than before. The model brings clinicians one step closer to more accurately determining whether a child was the victim of an accident or of abuse.
Coats and her team are currently researching how much force is required to damage these tethers, and if they heal or are replaced with scar tissue. This information could help physicians decide whether an area of the brain where the tethers were damaged is now more susceptible to injury. This research also could help athletes such as football players determine whether they have suffered enough damage to put them at risk for more serious injury later.
“It would mean an objective, more accurate way of diagnosing mild traumatic brain injury, as opposed to relying solely on a victim’s symptoms,” Coats said. “Mild TBI is dangerous because a person may feel OK and go back out into their regular daily activities, then get a second impact in which the injuries can be much worse.”
Currently, however, there is no scanning device that looks for damage in this subarachnoid space, but Coats believes her research will ultimately lead to one.
“If we came up with some tool to assess if these structures were damaged and we knew these damaged structures led to an increased risk for more serious head injury, we could develop more informed treatment strategies for managing patients with mild TBI.” she said.
Story courtesy of the University of Utah College of Engineering Research Report 2015
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