Abstract: Brain swelling is a serious condition associated with an accumulation of fluid inside the brain that can be caused by trauma, stroke, infection, or tumors. It increases the pressure inside the skull and reduces blood and oxygen supply. To relieve the intracranial pressure, neurosurgeons remove part of the skull and allow the swollen brain to bulge outward, a procedure known as decompressive craniectomy. Decompressive craniectomy has been preformed for more than a century; yet, its effects on the swollen brain remain poorly understood. Here we characterize the deformation, strain, and stretch in bulging brains using the nonlinear field theories of mechanics. Our study shows that even small swelling volumes of 28 to 56 ml induce maximum principal strains in excess of 30%. For radially outward-pointing axons, we observe maximal normal stretches of 1.3 deep inside the bulge and maximal tangential stretches of 1.3 around the craniectomy edge. While the stretch magnitude varies with opening site and swelling region, our study suggests that the locations of maximum stretch are universally shared amongst all bulging brains. Our model can inform neurosurgeons and rationalize the shape and position of the skull opening, with the overall goal to reduce brain damage and improve the structural and functional outcomes of decompressive craniectomy in trauma patients.
Recommendations
- The mechanics of decompressive craniectomy: bulging in idealized geometries
- Brain tissue deforms similarly to filled elastomers and follows consolidation theory
- Quantification of stretching in the ventricular wall and corpus callosum and corticospinal tracts in hydrocephalus before and after ventriculoperitoneal shunt operation
- scientific article; zbMATH DE number 1342722
- The hydromechanics of hydrocephalus: Steady-state solutions for cylindrical geometry
Cites work
- Biomechanics of traumatic brain injury
- Brain tissue deforms similarly to filled elastomers and follows consolidation theory
- Contact Mechanics
- Large deformation isotropic elasticity – on the correlation of theory and experiment for incompressible rubberlike solids
- Large elastic deformations of isotropic materials IV. further developments of the general theory
- Nonlinear solid mechanics. A continuum approach for engineering
- The mechanics of decompressive craniectomy: bulging in idealized geometries
- The solution of elasticity problems for the half-space by the method of Green and Collins
Cited in
(5)- The mechanics of decompressive craniectomy: bulging in idealized geometries
- Insights into the microstructural origin of brain viscoelasticity. Prospects for microstructure-informed constitutive modeling
- On the importance of using region-dependent material parameters for full-scale human brain simulations
- Likely equilibria of stochastic hyperelastic spherical shells and tubes
- Preface
This page was built for publication: Bulging brains
Report a bug (only for logged in users!)Click here to report a bug for this page (MaRDI item Q1679538)
