Skip to main content
Log in

Influence of the benign enlargement of the subarachnoid space on the bridging veins strain during a shaking event: a finite element study

  • Technical Note
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

There is controversy regarding the influence of the benign enlargement of the subarachnoid space on intracranial injuries in the field of the shaken baby syndrome. In the literature, several terminologies exists to define this entity illustrating the lack of unicity on this theme, and often what is “benign” enlargement is mistaken with an old subdural bleeding or with abnormal enlargement due to brain pathology. This certainly led to mistaken conclusions. To investigate the influence of the benign enlargement of the subarachnoid space on child head injury and especially its influence on the bridging veins, we used a finite element model of a 6-month-old child head on which the size of the subarachnoid space was modified. Regarding the bridging veins strain, which is at the origin of the subdural bleeding when shaking an infant, our results show that the enlargement of the subarachnoid space has a damping effect which reduces the relative brain/skull displacement. Our numerical simulations suggest that the benign enlargement of the subarachnoid space may not be considered as a risk factor for subdural bleeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Briner S, Bodensteiner J (1981) Benign subdural collections of infancy. Pediatrics 67(6):802–804

    PubMed  CAS  Google Scholar 

  2. Azais M, Echenne B (1992) Idiopathic pericerebral swelling (external hydrocephalus) of infants. Ann Pediatr (Paris) 39(9):550–558, Nov

    CAS  Google Scholar 

  3. Kleinman PK, Zito JL, Davidson RI, Raptopoulos V (1983) The subarachnoid spaces in children: normal variations in size. Radiology 147(2):455–457, May

    PubMed  CAS  Google Scholar 

  4. Veyrac C, Couture A, Baud C (1990) Pericerebral fluid collections and ultrasound. Pediatr Radiol 20(4):236–240

    Article  PubMed  CAS  Google Scholar 

  5. Wilms G, Vanderschueren G, Demaerel PH, Smet MH, Van Calenbergh F, Plets C, Goffin J, Casaer P (1993) CT and MR in infants with pericerebral collections and macrocephaly: benign enlargement of the subarachnoid spaces versus subdural collections. AJNR Am J Neuroradiol 14(4):855–860, Jul-Aug

    PubMed  CAS  Google Scholar 

  6. Aoki N (1994) Accidental head trauma and retinal hemorrhage. Neurosurgery 34(4):771, Apr

    Article  PubMed  CAS  Google Scholar 

  7. Aoki N, Masuzawa H (1984) Infantile acute subdural hematoma. Clinical analysis of 26 cases. J Neurosurg 61(2):273–280, Aug

    PubMed  CAS  Google Scholar 

  8. Howard MA, Bell BA, Uttley D (1993) The pathophysiology of infant subdural haematomas. Br J Neurosurg 7(4):355–365

    Article  PubMed  CAS  Google Scholar 

  9. Ikeda A, Sato O, Tsugane R, Shibuya N, Yamamoto I, Shimoda M (1987) Infantile acute subdural hematoma. Childs Nerv Syst 3(1):19–22

    Article  PubMed  CAS  Google Scholar 

  10. Kapila A, Trice J, Spies WG, Siegel BA, Gado MH (1982) Enlarged cerebrospinal fluid spaces in infants with subdural hematomas. Radiology 142(3):669–672, Mar

    PubMed  CAS  Google Scholar 

  11. McNeely PD, Atkinson JD, Saigal G, O’Gorman AM, Farmer JP (2006) Subdural hematomas in infants with benign enlargement of the subarachnoid spaces are not pathognomonic for child abuse. AJNR Am J Neuroradiol 27(8):1725–1728, Sep

    PubMed  CAS  Google Scholar 

  12. Roth S, Raul JS, Ludes B, Willinger R (2007) Finite element analysis of impact and shaking inflicted to a child. Int J Legal Med 121(3):223–228, May

    Article  PubMed  Google Scholar 

  13. Raul JS, Deck C, Willinger R, Ludes B (2008) Finite element models of the human head and their applications in forensic practice. Int J Legal Med (in press)

  14. Roth S, Raul JS, Willinger R (2008) Biofidelic child head FE model to simulate real world trauma. Comput Methods Programs Biomed 90(3):262–274, Jun

    Google Scholar 

  15. Raul JS, Deck C, Meyer F, Geraut A, Willinger R, Ludes B (2007) A finite element model investigation of gunshot injury. Int J Legal Med 121(2):143–146, Mar

    Article  PubMed  Google Scholar 

  16. Raul JS, Baumgartner D, Willinger R, Ludes B (2006) Finite element modelling of human head injuries caused by a fall. Int J Legal Med 120(4):212–218, Jul

    Article  PubMed  Google Scholar 

  17. Duhaime AC, Gennarelli TA, Thibault LE, Bruce DA, Margulies SS, Wiser R (1987) The shaken baby syndrome. A clinical, pathological and biomechanical study. J Neurosurg 66:409–415

    PubMed  CAS  Google Scholar 

  18. Prange MT, Coats B, Duhaime AC, Margulies SS (2003) Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants. J Neurosurg 99:143–150

    Article  PubMed  Google Scholar 

  19. Yamashima T, Friede RL (1984) Why do bridging veins rupture into the virtual subdural space? J Neurol Neurosurg Psychiatry 47(2):121–127, Feb

    PubMed  CAS  Google Scholar 

  20. Hymel KP, Jenny C, Block RW (2002) Intracranial hemorrhage and rebleeding in suspected victims of abusive head trauma: addressing the forensic controversies. Child Maltreat 7(4):329–348, Nov

    Article  PubMed  Google Scholar 

  21. Kleinman PK, Barnes PD (1998) Head trauma. In: Kleinman PK (ed) Diagnostic imaging of child abuse, 2nd edn. Mosby, St Louis

    Google Scholar 

  22. Chazal J, Irthum B, Janny P (1989) Ventricular subarachnoidal hydrocephalus of arachnoid villi origin. Neurochirurgie 35(6):379–382

    PubMed  CAS  Google Scholar 

  23. Robertson WC Jr, Chun RW, Orrison WW, Sackett JF (1979) Benign subdural collections of infancy. J Pediatr 94(3):382–386, Mar

    Article  PubMed  Google Scholar 

  24. Papasian NC, Frim DM (2000) A theoretical model of benign external hydrocephalus that predicts a predisposition towards extra-axial hemorrhage after minor head trauma. Pediatr Neurosurg 33(4):188–193, Oct

    Article  PubMed  CAS  Google Scholar 

  25. Baker AB (1938) Subdural hematoma. Arch Pathol Lab Med 26:535–559

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean-Sébastien Raul.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Raul, JS., Roth, S., Ludes, B. et al. Influence of the benign enlargement of the subarachnoid space on the bridging veins strain during a shaking event: a finite element study. Int J Legal Med 122, 337–340 (2008). https://doi.org/10.1007/s00414-008-0242-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-008-0242-6

Keywords

Navigation