A sporting chance against brain injury
Our skulls may be hard, but what’s inside is up to 20 times softer than jelly, which is why researchers are working to better understand brain trauma and how it can be avoided
Aidan Price of Bohemians with David McMillan, then of St Patrick’s Athletic, after a clash of heads at Richmond Park, Dublin. Photograph: Inpho/Donall Farmer
What happens when two heads collide on a hurling, rugby, soccer or other sports pitch? The human skull is particularly resistant to shocks and hard to fracture, but how tough are its contents?
When tested in the lab, brain matter turns out not to be as stiff as you might think (see panel). This softness explains why we can be vulnerable to head impacts and traumas, whether due to accidents, bomb blasts or repetitive sport moves (think of the thousands of times footballers practise headers during their careers).
At the DCU centre for medical engineering research, Dr Jerry Murphy works on measuring the engineering characteristics of brain matter. “Surprisingly little is known about its most basic aspects, such as its stiffness, its resistance to tear or its response to shearing or twisting forces,” he says. “By measuring these, we will be able to design better body protection in cars and better helmets in sports.”
Currently most helmets only deal with head-on impact scenarios. They do not especially protect the area below the temporal bone on the base of the skull, which is thin and vulnerable to side impacts, nor can they protect from twisting motions, which can be very damaging to neurons – special cells that are the brain’s pathways for information.
Dr Murphy has just joined a new delocalised laboratory, the International Brain Mechanics and Trauma Lab, which originated at the University of Oxford and is trying to test and model brain matter as if it were an engineering material. The ultimate goal of the lab is to uncover the relations between brain-tissue mechanics and brain function, diseases and trauma.
US military research
The US military drove early efforts in this research area. It was trying to understand what happens to the brain inside the skull when it is protected by body armour against projectiles but is still damaged by explosion blasts.
“It could be that the high-pressure wave generated by the explosion bounces longer inside the skull because of the hard shell helmets,” say Prof Antoine Jerusalem and Prof Alain Goriely, the co-founders of the lab at Oxford. “This is another example of a poorly understood mechanical effect that can lead to impairment. Clearly we need to pool resources and expertise together to tackle these questions at cell, tissue and medical levels.”
The international lab involves the partnership of more than 20 researchers from 12 main international centres, including DCU and NUI Galway, alongside MIT, Stanford and other major institutions.
Medical doctors will eventually be the main benefactors of the research, and the list of participants includes top specialists in neuropathology, neurosurgery, and neuro-oncology at Oxford’s John Radcliffe Hospital.
Typically, neurosurgeons must operate under complicated constraints due to restricted access to the brain. Some neurological diseases are located in specific regions of the brain, where surgeons must operate with high accuracy, sometimes at the millimetre scale.
“In the hundred or so years that neurosurgery has become a discipline of its own, very little progress has been made in improving the survival rates of adult patients suffering from what we call ‘high-grade cancer tumours’,” says Dr Nick de Pennington, neurosurgery registrar at John Radcliffe Hospital. “It still stands at 12-18 months, max.”