Biomechanics of Traumatic Brain Injury
Ommaya’s cetripedal theory identified that the effects always begin at the surface of the brain in mild injury and extend inward to affect the diencephalic- mesencephalic core in more severe injury.20 His work showed that both translational and rotational acceleration produce focal lesions but that only rotational acceleration produced diffuse axonal injury. When damage is found in the rostral brainstem it is also associated with diffuse hemispheric damage. Prior to his work it was believed that the mechanism of consciousness was linked to primary brainstem injury. However, the brainstem and mesencephalon are the last structure to be affected in severe injury, and rotational rather than translational forces produce concussion. Contact phenomenon contribute to the development of focal lesions, e.g. frontal and temporal lesions due to contact with the sphenoid bone.18 Magnetic resonance imaging (MRI) studies have supported these theories. 11, 12 They have confirmed that the distribution of lesions follows a centripetal pattern that follows injury severity identified by the Glascow Coma Score.
Read more about this topic: Ayub K. Ommaya
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