Goldsmith Werner, Plunkett John
Graduate School, Departments of Mechanical Engineering and Bioengineering, University of California, Berkeley, California, USA.
Am J Forensic Med Pathol. 2004 Jun;25(2):89-100. doi: 10.1097/01.paf.0000127407.28071.63.
There is significant disagreement among medical professionals regarding the mechanisms for infant brain injury. This disagreement is due in part to the failure by some to acknowledge and incorporate known biomechanical data and models into hypotheses regarding causes. A proper biomechanical understanding of the mechanisms of traumatic brain injury (TBI) challenges many published and testified assumptions regarding TBI in infants and children. This paper analyzes the biomechanical relationship between the causes of TBI in infants and children, and their physiological consequences. Loading characteristics, injury parameters and criteria, scaling, failure characteristics, differences between infants and adults, and impact due to falls are described and discussed in the context of the laws of mechanics. Recent studies are critiqued with reference to their contribution to an understanding of brain injury mechanisms. Finally, methods for improving our currently incomplete knowledge of infant head injuries, and their mechanisms, consequences and tolerances are proposed. There is an urgent need for close collaboration between physicians and biomechanicians to objectively and scientifically evaluate infant head injuries to further define their mechanical bases, and to assist in their diagnosis and treatment.
医学专业人士对于婴儿脑损伤的机制存在重大分歧。这种分歧部分归因于一些人未能认识到并将已知的生物力学数据和模型纳入有关病因的假设中。对创伤性脑损伤（TBI）机制的恰当生物力学理解对许多已发表和经证实的关于婴儿和儿童TBI的假设提出了挑战。本文分析了婴儿和儿童TBI病因与其生理后果之间的生物力学关系。在力学定律的背景下描述并讨论了加载特性、损伤参数和标准、缩放比例、失效特性、婴儿与成人之间的差异以及跌倒造成的影响。参考近期研究对理解脑损伤机制的贡献进行了批判。最后，提出了改善我们目前对婴儿头部损伤及其机制、后果和耐受性的不完整认识的方法。迫切需要医生和生物力学专家密切合作，以客观、科学地评估婴儿头部损伤，进一步明确其力学基础，并协助进行诊断和治疗。
