Journal of Pediatric Neurology 2020; 18(05): 223-230
DOI: 10.1055/s-0040-1708495
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Cerebrospinal Fluid Interaction with Cerebral Cortex during Pediatric Abusive Head Trauma

1  Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury Campus, Northern Boulevard, Old Westbury, New York, United States
2  Department of Mechanical Engineering, College of Engineering & Computing Sciences, New York Institute of Technology, Old Westbury Campus, Northern Boulevard, Old Westbury, New York, United States
,
2  Department of Mechanical Engineering, College of Engineering & Computing Sciences, New York Institute of Technology, Old Westbury Campus, Northern Boulevard, Old Westbury, New York, United States
,
Rosalyn Chan-Akaley
3  Lang Research Center, NewYork-Presbyterian Queens, Flushing, New York, United States
,
Paul D. H. Nguyen
4  Pennsylvania State College of Medicine, Hershey, Pennsylvania, United States
,
Hallie Zwibel
5  Department of Sports Medicine, College of Osteopathic Medicine, New York Institute of Technology, Westbury Campus, Northern Boulevard, Old Westbury, New York, United States
› Author Affiliations
Funding This study was funded by a seed grant provided by the New York Institute of Technology and a donation from the New York Thoroughbred Horsemen's Association.
Further Information

Publication History

12 November 2019

26 January 2020

Publication Date:
05 April 2020 (online)

Abstract

Abusive head trauma is the leading cause of fatal brain injuries in children younger than 2 years. It is a preventable and severe form of physical child abuse often linked to the forceful shaking of an infant or toddler. Victims of abusive head trauma can suffer permanent neurological damage, resulting in developmental delay and disability. The long-term effects of abusive head trauma are difficult to diagnose and predict. In this model, we use a high-order finite element method paired with the most comprehensive and current head/brain model and next-generation smoothed particle hydrodynamics. This is one of the first fluid–structure interaction frameworks that uses fluid material properties to represent the cerebrospinal fluid (CSF) while including all major anatomical features of the brain. The interaction of CSF with the brain cortex during abusive head trauma is demonstrated during multiple shaking cycles. A comprehensive and precise model that calculates for the role of CSF in neurological trauma will be useful both in the prevention and treatment of abusive head trauma and the determination of prognosis and patient outcomes.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.