An Objective Injury Threshold for the Maximum Principal Strain Criterion for Brain Tissue in the Finite Element Head Model and Its Application.

Although the finite element head model (FEHM) has been widely utilized to analyze injury locations and patterns in traumatic brain injury, significant controversy persists regarding the selection of a mechanical injury variable and its corresponding threshold. This paper aims to determine an objective injury threshold for maximum principal strain (MPS) through a novel data-driven method, and to validate and apply it. We extract the peak responses from all elements across 100 head impact simulations to form a dataset, and then determine the objective injury threshold by analyzing the relationship between the combined injury degree and the threshold according to the stationary value principle. Using an occipital impact case from a clinical report as an example, we evaluate the accuracy of the injury prediction based on the new threshold. The results show that the injury area predicted by finite element analysis closely matches the main injury area observed in CT images, without the issue of over- or underestimating the injury due to an unreasonable threshold. Furthermore, by applying this threshold to the finite element analysis of designed occipital impacts, we observe, for the first time, supra-tentorium cerebelli injury, which is related to visual memory impairment. This discovery may indicate the biomechanical mechanism of visual memory impairment after occipital impacts reported in clinical cases.