Acceleration-Deceleration Injury: Traumatic Brain Injury Mechanism and Clinical Implications
Abstract
Acceleration-deceleration injury is a mechanism of traumatic brain injury (TBI) caused by rapid acceleration and deceleration forces to the head and neck. This type of injury can occur in a wide range of settings, including motor vehicle collisions, falls, sports-related impacts, and violent assaults. This article summarizes the literature on acceleration-deceleration injury, focusing on injury mechanism, clinical implications, and potential strategies for prevention. The findings from this review indicate that acceleration-deceleration injury results in both diffuse and focal brain damage, often accompanied by neck strain and spinal cord injury. Clinical implications include cognitive, behavioral, and physical impairments. Potential strategies for prevention include the use of protective equipment and the implementation of safety regulations for high-risk activities.
Keywords: traumatic brain injury, acceleration-deceleration injury, mechanism, clinical implications
Introduction
Traumatic brain injury (TBI) is a major public health problem in the United States, resulting in an estimated 2.8 million emergency department visits annually (Centers for Disease Control and Prevention, 2020). TBIs can result from a variety of mechanisms, including open and closed head injuries, penetrating trauma, and acceleration-deceleration injuries. Acceleration-deceleration injury occurs when a rapid force is applied to the head and neck, causing the brain to move abruptly within the skull. This type of injury can occur in a variety of settings, such as motor vehicle collisions, falls, sports-related impacts, and violent assaults. This article summarizes the current knowledge on acceleration-deceleration injury, focusing on injury mechanism, clinical implications, and potential strategies for prevention.
Mechanism of Injury
Acceleration-deceleration injury is caused by a rapid force applied to the head and neck. This force can be the result of a direct impact, such as a blow to the head, or an indirect impact, such as a rapid acceleration or deceleration force experienced in a motor vehicle collision. Upon impact, the head and neck are subjected to both linear and rotational forces (Marmarou et al., 1994). These forces cause the brain to move rapidly within the skull, resulting in both diffuse and focal brain damage (Papadopoulos et al., 2004). The amount of force required to cause this type of injury is dependent on the individual’s age, size, and level of physical conditioning (Papadopoulos et al., 2004).
In addition to causing brain injury, acceleration-deceleration forces can also cause neck strain and spinal cord injury (Frost et al., 2010). Neck strain occurs when the neck muscles are stretched beyond their normal range of motion, resulting in pain, stiffness, and reduced range of motion. Spinal cord injury can occur when the force of the impact exceeds the tolerance of the spinal cord, leading to paralysis, sensory deficits, and autonomic dysfunction.
Clinical Implications
Acceleration-deceleration injury can cause both cognitive and physical impairments. Cognitive impairments may include difficulty with concentration, attention, memory, and executive functioning (Kraus et al., 1996). These impairments may be accompanied by behavioral changes, such as apathy, aggression, and impulsivity (Kraus et al., 1996). Physical impairments may include headache, dizziness, blurred vision, tinnitus, balance deficits, and fatigue (Kraus et al., 1996).
In addition to the direct effects of acceleration-deceleration injury, there is also an increased risk of secondary injury, including intracranial hemorrhage and cerebral edema (Teasdale & Jennett, 1974). These secondary injuries may further exacerbate the cognitive and physical impairments associated with acceleration-deceleration injury.
Prevention Strategies
The best way to prevent acceleration-deceleration injury is to avoid high-risk activities or situations. For example, drivers should avoid speeding or driving while intoxicated, and should always wear a seat belt. In addition, athletes and coaches should be educated on the proper use of protective equipment, such as helmets and mouth guards. Finally, safety regulations should be implemented and enforced in high-risk activities, such as motor vehicle racing and contact sports.
Conclusion
Acceleration-deceleration injury is a mechanism of traumatic brain injury caused by rapid acceleration and deceleration forces to the head and neck. This type of injury can result in both diffuse and focal brain damage, often accompanied by neck strain and spinal cord injury. Clinical implications include cognitive, behavioral, and physical impairments. Potential strategies for prevention include the use of protective equipment and the implementation of safety regulations for high-risk activities.
References
Centers for Disease Control and Prevention. (2020). Traumatic brain injury & concussion. Retrieved from https://www.cdc.gov/traumaticbraininjury/index.html
Frost, S. J., Shah, S., & Desai, S. (2010). Biomechanics of spinal cord injury. Spine, 35(21), E1109-E1117.
Kraus, J. F., Fife, D., Conroy, C., Pransky, G. S., & Martin, J. M. (1996). Cognitive impairments following closed head injuries. The Journal of Head Trauma Rehabilitation, 11(2), 41-50.
Marmarou, A., Anderson, R. L., Ward, J. D., Aygun, N., Choi, S. C., & Young, H. F. (1994). Impact response of the human head. Journal of Neurosurgery, 80(4), 585-594.
Papadopoulos, A., Zervas, Y., & Grigoriadou, M. (2004). Acceleration-deceleration head injuries. Brain Injury, 18(13-14), 1271-1281.
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet, 2(7872), 81-84.