Research Reports - A comparison in a youth population between those with and without a history of concussion using biomechanical reconstruction

J Neurosurg Pediatr. 2017 Jan 27:1-9. doi: 10.3171/2016.10.PEDS16449. [Epub ahead
of print]

Post A(1,)(2), Hoshizaki TB(2), Gilchrist MD(3), Koncan D(2), Dawson L(2), Chen
W(2), Ledoux AA(1), Zemek R(1); Pediatric Emergency Research Canada (PERC) 5P
Concussion Team.

OBJECTIVE Concussion is a common topic of research as a result of the short- and
long-term effects it can have on the affected individual. Of particular interest
is whether previous concussions can lead to a biomechanical susceptibility, or
vulnerability, to incurring further head injuries, particularly for youth
populations. The purpose of this research was to compare the impact biomechanics
of a concussive event in terms of acceleration and brain strains of 2 groups of
youths: those who had incurred a previous concussion and those who had not. It
was hypothesized that the youths with a history of concussion would have
lower-magnitude biomechanical impact measures than those who had never suffered a
previous concussion. METHODS Youths who had suffered a concussion were recruited
from emergency departments across Canada. This pool of patients was then
separated into 2 categories based on their history of concussion: those who had
incurred 1 or more previous concussions, and those who had never suffered a
concussion. The impact event that resulted in the brain injury was reconstructed
biomechanically using computational, physical, and finite element modeling
techniques. The output of the events was measured in biomechanical parameters
such as energy, force, acceleration, and brain tissue strain to determine if
those patients who had a previous concussion sustained a brain injury at lower
magnitudes than those who had no previously reported concussion. RESULTS The
results demonstrated that there was no biomechanical variable that could
distinguish between the concussion groups with a history of concussion versus no
history of concussion. CONCLUSIONS The results suggest that there is no
measureable biomechanical vulnerability to head impact related to a history of
concussions in this youth population. This may be a reflection of the long time
between the previous concussion and the one reconstructed in the laboratory,
where such a long period has been associated with recovery from injury. 

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