The Relationship Between Subconcussive Impacts and Concussion History on Clinical Measures of Neurologic Function in Collegiate Football Players

Concussions sustained during college and professional football careers have been associated with both acute and chronic neurologic impairment. The contribution of subconcussive impacts to this impairment has not been adequately studied. Therefore, we investigated the relationship between subconcussive impacts and concussion history on clinical measures of neurologic function. Forty-six collegiate football players completed five clinical measures of neurologic function commonly employed in the evaluation of concussion before and after a single season. These tests included the Automated Neuropsychological Assessment Metrics, Sensory Organization Test, Standardized Assessment of Concussion, Balance Error Scoring System, and Graded Symptom Checklist. The Head Impact Telemetry (HIT) System recorded head impact data including the frequency, magnitude, and location of impacts. College football players sustain approximately 1,000 subconcussive impacts to the head over the course of a season, but for the most part, do not demonstrate any clinically meaningful changes from preseason to postseason on measures of neurologic function. Changes in performance were mostly independent of prior concussion history, and the total number, magnitude and location of sustained impacts over one season as observed R ² values ranged between 0.30 and 0.35. Repetitive subconcussive head impacts over a single season do not appear to result in short-term neurologic impairment, but these relationships should be further investigated for a potential dose–response over a player’s career.     

Maximum Principal Strain and Strain Rate Associated with Concussion Diagnosis Correlates with Changes in Corpus Callosum White Matter Indices

On-field monitoring of head impacts, combined with finite element (FE) biomechanical simulation, allow for predictions of regional strain associated with a diagnosed concussion. However, attempts to correlate these predictions with in vivo measures of brain injury have not been published. This article reports an approach to and preliminary results from the correlation of subject-specific FE model-predicted regions of high strain associated with diagnosed concussion and diffusion tensor imaging to assess changes in white matter integrity in the corpus callosum (CC). Ten football and ice hockey players who wore instrumented helmets to record head impacts sustained during play completed high field magnetic resonance imaging preseason and within 10 days of a diagnosed concussion. The Dartmouth Subject-Specific FE Head model was used to generate regional predictions of strain and strain rate following each impact associated with concussion. Maps of change in fractional anisotropy (FA) and median diffusivity (MD) were generated for the CC of each athlete to correlate strain with change in FA and MD. Mean and maximum strain rate correlated with change in FA (Spearman ρ = 0.77, p = 0.01; 0.70, p = 0.031), and there was a similar trend for mean and maximum strain (0.56, p = 0.10; 0.6, p = 0.07), as well as for maximum strain with change in MD (−0.63, p = 0.07). Change in MD correlated with injury-to-imaging interval (ρ = −0.80, p = 0.006) but change in FA did not (ρ = 0.18, p = 0.62). These results provide preliminary confirmation that model-predicted strain and strain rate in the CC correlate with changes in indices of white matter integrity.     

Parametric Comparisons of Intracranial Mechanical Responses from Three Validated Finite Element Models of the Human Head

A number of human head finite element (FE) models have been developed from different research groups over the years to study the mechanisms of traumatic brain injury. These models can vary substantially in model features and parameters, making it important to evaluate whether simulation results from one model are readily comparable with another, and whether response-based injury thresholds established from a specific model can be generalized when a different model is employed. The purpose of this study is to parametrically compare regional brain mechanical responses from three validated head FE models to test the hypothesis that regional brain responses are dependent on the specific head model employed as well as the region of interest (ROI). The Dartmouth Scaled and Normalized Model (DSNM), the Simulated Injury Monitor (SIMon), and the Wayne State University Head Injury Model (WSUHIM) were selected for comparisons. For model input, 144 unique kinematic conditions were created to represent the range of head impacts sustained by male collegiate hockey players during play. These impacts encompass the 50th, 95th, and 99th percentile peak linear and rotational accelerations at 16 impact locations around the head. Five mechanical variables (strain, strain rate, strain × strain rate, stress, and pressure) in seven ROIs reported from the FE models were compared using Generalized Estimating Equation statistical models. Highly significant differences existed among FE models for nearly all output variables and ROIs. The WSUHIM produced substantially higher peak values for almost all output variables regardless of the ROI compared to the DSNM and SIMon models (p < 0.05). DSNM also produced significantly different stress and pressure compared with SIMon for all ROIs (p < 0.05), but such differences were not consistent across ROIs for other variables. Regardless of FE model, most output variables were highly correlated with linear and rotational peak accelerations. The significant disparities in regional brain responses across head models regardless of the output variables strongly suggest that model-predicted brain responses from one study should not be extended to other studies in which a different model is utilized. Consequently, response-based injury tolerance thresholds from a specific model should not be generalized to other studies either in which a different model is used. However, the similar relationships between regional responses and the linear/rotational peak accelerations suggest that each FE model can be used independently to assess regional brain responses to impact simulations in order to perform statistical correlations with medical images and/or well-selected experiments with documented injury findings.     

The Effects of Visual Distracter Complexity on Auditory Evoked P3b in Contact Sports Athletes

“Classic” P3b auditory oddball paradigms are insensitive to subtle deficits. An auditory oddball paradigm paired with visual distracters was used to compare football players with history of concussion, football players without history of concussion, and non-contact sport athletes. As hypothesized, increasing complexity of, and attention to, visual distracters reduced P3b amplitude. P3b amplitudes from non-contact athletes were larger than those from football players; however, players with and without a history of concussion were not significantly different. An auditory oddball paradigm with simple visual distracter improves sensitivity to cognitive deficits. Subconcussive impacts may contribute to brain damage frequently attributed to concussions.     

Rotational Head Kinematics in Football Impacts: An Injury Risk Function for Concussion

Recent research has suggested a possible link between sports-related concussions and neurodegenerative processes, highlighting the importance of developing methods to accurately quantify head impact tolerance. The use of kinematic parameters of the head to predict brain injury has been suggested because they are indicative of the inertial response of the brain. The objective of this study is to characterize the rotational kinematics of the head associated with concussive impacts using a large head acceleration dataset collected from human subjects. The helmets of 335 football players were instrumented with accelerometer arrays that measured head acceleration following head impacts sustained during play, resulting in data for 300,977 sub-concussive and 57 concussive head impacts. The average sub-concussive impact had a rotational acceleration of 1230 rad/s² and a rotational velocity of 5.5 rad/s, while the average concussive impact had a rotational acceleration of 5022 rad/s² and a rotational velocity of 22.3 rad/s. An injury risk curve was developed and a nominal injury value of 6383 rad/s² associated with 28.3 rad/s represents 50% risk of concussion. These data provide an increased understanding of the biomechanics associated with concussion and they provide critical insight into injury mechanisms, human tolerance to mechanical stimuli, and injury prevention techniques.     

Validation of Concussion Risk Curves for Collegiate Football Players Derived from HITS Data

For several years, Virginia Tech and other schools have measured the frequency and severity of head impacts sustained by collegiate American football players in real time using the Head Impact Telemetry (HIT) System of helmet-mounted accelerometers. In this study, data from 37,128 head impacts collected at Virginia Tech during games from 2006 to 2010 were analyzed. Peak head acceleration exceeded 100 g in 516 impacts, and the Head Injury Criterion (HIC) exceeded 200 in 468 impacts. Four instrumented players in the dataset sustained a concussion. These data were used to develop risk curves for concussion as a function of peak head acceleration and HIC. The validity of this biomechanical approach was assessed using epidemiological data on concussion incidence from other sources. Two specific aspects of concussion incidence were addressed: the variation by player position, and the frequency of repeat concussions. The HIT System data indicated that linemen sustained the highest overall number of head impacts, while skill positions sustained a higher number of more severe head impacts (peak acceleration > 100 g or HIC > 200). When weighted using injury risk curves, the HIT System data predicted a higher incidence of concussion in skill positions compared to linemen at rates that were in strong agreement with the epidemiological literature (Pearson’s r = 0.72–0.87). The predicted rates of repeat concussions (21–39% over one season and 33–50% over five seasons) were somewhat higher than the ranges reported in the epidemiological literature. These analyses demonstrate that simple biomechanical parameters that can be measured by the HIT System possess a high level of power for predicting concussion.     

The Effect of Play Type and Collision Closing Distance on Head Impact Biomechanics

Football accounts for 55% of concussions to collegiate athletes. In the National Football League, players are at a greater risk for concussion during kickoffs and punts compared to rushing and passing plays. The two primary purposes of this study were to determine if game-related special teams head impacts were greater in magnitude than head impacts sustained during offensive and defensive plays, and to better understand the effect closing distance between players (short vs. long) had on head impact magnitude. Collegiate football players were enrolled in a prospective cohort study assessing head impact biomechanics during special teams, offensive, and defensive collisions; long closing distance (≥10 yards) and short closing distance (<10 yards) impacts were also studied. Data were analyzed using random intercepts general linear mixed models. Long closing distance collisions generated more severe head impacts than short closing distances. Collisions occurring on special teams plays over long closing distances were most severe while collisions occurring on special teams and defensive plays over short closing distances resulted in the least severe impacts. Decreasing the impact severity of collisions in collegiate football may be accomplished by reducing the closing distance prior to impact.     

Head Impact Exposure in Youth Football: High School Ages 14 to 18 Years and Cumulative Impact Analysis

Sports-related concussion is the most common athletic head injury with football having the highest rate among high school athletes. Traditionally, research on the biomechanics of football-related head impact has been focused at the collegiate level. Less research has been performed at the high school level, despite the incidence of concussion among high school football players. The objective of this study is to twofold: to quantify the head impact exposure in high school football, and to develop a cumulative impact analysis method. Head impact exposure was measured by instrumenting the helmets of 40 high school football players with helmet mounted accelerometer arrays to measure linear and rotational acceleration. A total of 16,502 head impacts were collected over the course of the season. Biomechanical data were analyzed by team and by player. The median impact for each player ranged from 15.2 to 27.0 g with an average value of 21.7 (±2.4) g. The 95th percentile impact for each player ranged from 38.8 to 72.9 g with an average value of 56.4 (±10.5) g. Next, an impact exposure metric utilizing concussion injury risk curves was created to quantify cumulative exposure for each participating player over the course of the season. Impacts were weighted according to the associated risk due to linear acceleration and rotational acceleration alone, as well as the combined probability (CP) of injury associated with both. These risks were summed over the course of a season to generate risk weighted cumulative exposure. The impact frequency was found to be greater during games compared to practices with an average number of impacts per session of 15.5 and 9.4, respectively. However, the median cumulative risk weighted exposure based on combined probability was found to be greater for practices vs. games. These data will provide a metric that may be used to better understand the cumulative effects of repetitive head impacts, injury mechanisms, and head impact exposure of athletes in football.     

Up-regulation of reactivity and survival genes in astrocytes after exposure to short duration overpressure

Gurdjian et al. proposed decades ago that pressure gradients played a major factor in neuronal injury due to impact. In the late 1950s, their experiments on concussion demonstrated that the principal factor in the production of concussion in animals was the sudden increase of intracranial pressure accompanying head injury. They reported the increase in pressure severity correlated with an increase in 'altered cells' resulting in animal death. More recently, Hardy et al. (2006) demonstrated the presence of transient pressure pulses with impact conditions. These studies indicate that short duration overpressure should be further examined as a mechanism of traumatic brain injury (TBI). In the present study, we designed and fabricated a barochamber that simulated overpressure noted in various head injury studies. We tested the effect of overpressure on astrocytes. Expressions of apoptotic, reactivity and survival genes were examined at 24, 48 and 72 h post-overpressure exposure. At 24 h, we found elevated levels of reactivity and survival gene expression. By 48 h, a decreased expression of apoptotic genes was demonstrated. This study reinforces the hypothesis that transient pressure acts to instigate the cellular response displayed following TBI.     

Classification of Sport-Related Head Trauma: A Spectrum of Mild to Severe Injury

OBJECTIVE: To identify the types of injuries the human brain incurs as a result of traumatic forces applied to the cranium. In athletic events and endeavors, the full spectrum of intracranial hemorrhages in various compartments, raised intracranial pressure, and diffuse nonhemorrhagic damage may be seen. In this review, we describe these serious injuries and the more common mild traumatic brain injury in their clinical presentations and relate concussion classification to the overall picture of traumatic brain injury. METHODS: Our cumulative experience with athletic injuries, both at the catastrophic and mild traumatic brain injury levels, has led us to a management paradigm that serves to guide us in the classification and treatment of these athletes. DISCUSSION: The occurrence of intracranial injuries in sports has now been well documented. Intracranial hematomas (epidural, subdural, and parenchymal) and cerebral contusions can result from head injury. Many patients sustain a diffuse brain injury, resulting in elevated intracranial pressures, without a blood clot or mass lesion. The classification of concussion and the use of concussion guidelines are not uniform. However, the major emphases are agreed upon: the close and careful scrutiny of the athlete, an expeditious but reliable neurologic examination, and proper on-field management. Return-to-play decisions are based on many factors that affect normal functioning, both on and off the playing field. CONCLUSIONS: Sufficient knowledge now exists to allow us to carefully evaluate the injured athlete, to place him or her in the management scheme to minimize the potential for permanent cerebral dysfunction, and to know when the athlete can safely return to contact sport participation.     

颅脑接触面的不同设置以及脑脊液单元划分密度对脑组织动态响应的影响

目的 探讨颅脑接触面不同定义方式和脑脊液（cerebrospinal fluid, CSF）单元划分密度对脑组织动态响应的影响。方法 基于第50百分位成人头部有限元模型,通过重构尸体直线撞击试验和旋转试验,将颅骨、CSF和脑组织之间定义为共节点、固连和滑动不分离接触面,研究不同接触面类型对脑组织动态响应的影响;颅骨、CSF和脑组织实现共节点接触,将CSF划分为1层和3层六面体单元并保持厚度不变,研究不同CSF划分密度对脑组织动态响应的影响。结果 颅内压力对不同接触面类型较敏感,但脑组织响应对不同CSF单元的划分层数不敏感。结论 研究结果对头部有限元模型中CSF构建以及颅脑接触界面的选择提供理论参考。     

Comparison of Ice Hockey Goaltender Helmets for Concussion Type Impacts

Concussions are among the most common injuries sustained by ice hockey goaltenders and can result from collisions, falls and puck impacts. However, ice hockey goaltender helmet certification standards solely involve drop tests to a rigid surface. This study examined how the design characteristics of different ice hockey goaltender helmets affect head kinematics and brain strain for the three most common impact events associated with concussion for goaltenders. A NOCSAE headform was impacted under conditions representing falls, puck impacts and shoulder collisions while wearing three different types of ice hockey goaltender helmet models. Resulting linear and rotational acceleration as well as maximum principal strain were measured for each impact condition. The results indicate that a thick liner and stiff shell material are desirable design characteristics for falls and puck impacts to reduce head kinematic and brain tissue responses. However for collisions, the shoulder being more compliant than the materials of the helmet causes insufficient compression of the helmet materials and minimizing any potential performance differences. This suggests that current ice hockey goaltender helmets can be optimized for protection against falls and puck impacts. However, given collisions are the leading cause of concussion for ice hockey goaltenders and the tested helmets provided little to no protection, a clear opportunity exists to design new goaltender helmets which can better protect ice hockey goaltenders from collisions.     

Frequency and location of head impact exposures in individual collegiate football players

Context:

Measuring head impact exposure is a critical step toward understanding the mechanism and prevention of sport-related mild traumatic brain (concussion) injury, as well as the possible effects of repeated subconcussive impacts.

Objective:

To quantify the frequency and location of head impacts that individual players received in 1 season among 3 collegiate teams, between practice and game sessions, and among player positions.

Design:

Cohort study.

Setting:

Collegiate football field.

Patients or Other Participants:

One hundred eighty-eight players from 3 National Collegiate Athletic Association football teams.

Intervention(s):

Participants wore football helmets instrumented with an accelerometer-based system during the 2007 fall season.

Main Outcome Measure(s):

The number of head impacts greater than 10g and location of the impacts on the player''s helmet were recorded and analyzed for trends and interactions among teams (A, B, or C), session types, and player positions using Kaplan-Meier survival curves.

Results:

The total number of impacts players received was nonnormally distributed and varied by team, session type, and player position. The maximum number of head impacts for a single player on each team was 1022 (team A), 1412 (team B), and 1444 (team C). The median number of head impacts on each team was 4.8 (team A), 7.5 (team B), and 6.6 (team C) impacts per practice and 12.1 (team A), 14.6 (team B), and 16.3 (team C) impacts per game. Linemen and linebackers had the largest number of impacts per practice and per game. Offensive linemen had a higher percentage of impacts to the front than to the back of the helmet, whereas quarterbacks had a higher percentage to the back than to the front of the helmet.

Conclusions:

The frequency of head impacts and the location on the helmet where the impacts occur are functions of player position and session type. These data provide a basis for quantifying specific head impact exposure for studies related to understanding the biomechanics and clinical aspects of concussion injury, as well as the possible effects of repeated subconcussive impacts in football.     

关于头部组织材料性能敏感性对颅内压力响应的研究

应用有限元法 (finiteelementmethod)和试验设计技术 (design of experimentDOE)研究人头部颅骨(skull)、脑脊液 (cerebral spinal fluidCSF)和脑髓 (brain)材料性能的敏感性对颅内因撞击而产生的压力响应。该研究采用头部的有限元模型 ,用三因子、三层次的因子试验设计对影响颅内因撞击而引起的压力的颅骨、脑脊液和脑髓的材料性质的敏感性进行分析。研究结果进一步证实了颅骨、脑脊液、脑髓的材料性能对颅内因撞击而引起的压力的重要影响。本研究为进一步的头部的有限元分析提供了新的见解 ,并提出了对头部组织的材料性能作更进一步的探索。     

Individual Impact Magnitude vs. Cumulative Magnitude for Estimating Concussion Odds

Helmeted impact devices have allowed researchers to investigate the biomechanics of head impacts in vivo. While increased impact magnitude has been associated with greater concussion risk, a definitive concussive threshold has not been established. It is likely that concussion risk is not determined by a single impact itself, but a host of predisposing factors. These factors may include genetics, fatigue, and/or prior head impact exposure. The objective of the current paper is to investigate the association between cumulative head impact magnitude and concussion risk. It is hypothesized that increased cumulative magnitudes will be associated with greater concussion risk. This retrospective analysis included participants that were recruited from regional high-schools in Illinois and Michigan from 2007 to 2014 as part of an ongoing study on concussion biomechanics. Across seven seasons, 185 high school football athletes were instrumented with the Head Impact Telemetry system. Out of 185 athletes, 31 (17%) sustained a concussion, with two athletes sustaining two concussions over the study period, yielding 33 concussive events. The system recorded 78,204 impacts for all concussed players. Linear acceleration, rotational acceleration, and head impact telemetry severity profile (HITsp) magnitudes were summed within five timeframes: the day of injury, three days prior to injury, seven days prior to injury, 30 days prior to injury, and prior in-season exposure. Logistic regressions were modeled to explain concussive events based on the singular linear acceleration, rotational acceleration, and HITsp event along with the calculated summations over time. Linear acceleration, rotational acceleration, and HITsp all produced significant models estimating concussion (p < 0.05). The strongest estimators of a concussive impact were the linear acceleration (OR = 1.040, p < 0.05), rotational acceleration (OR = 1.001, p < 0.05), and HITsp (OR = 1.003, p < 0.05) for the singular impact rather than any of the cumulative magnitude calculations. Moreover, no cumulative count measure was significant for linear or rotational acceleration. Results from this investigation support the growing literature indicating cumulative magnitude is not related to concussion likelihood. Cumulative magnitude is a simplistic measure of the total exposure sustained by a player over a given period. However, this measure is limited as it assumes the brain is a static structure unable to undergo self-repair. Future research should consider how biological recovery between impacts may influence concussion risk.     

颅脑组织材料参数对儿童头部冲击响应的影响

目的针对目前对儿童颅脑组织材料参数的不确定性,研究直接冲击载荷条件下颅脑组织材料参数对儿童头部冲击响应的影响。方法应用已验证的3岁儿童头部有限元模型进行冲击仿真实验,采用正交实验设计和方差分析对儿童颅脑组织材料进行参数分析。结果颅骨弹性模量对儿童头部冲击响应具有显著性影响,随着颅骨弹性模量的增加,头部撞击侧颅内压力显著减小(P=0.000),对撞侧颅内压力显著增大(P=0.000),颅骨最大Von Mises应力显著增大(P=0.000)。脑组织的线性黏弹性材料参数对儿童头部冲击响应同样具有显著性影响,随着脑组织短效剪切模量的增加,脑组织最大主应变显著减小(P=0.000),脑组织最大剪应力则显著增加(P=0.000)。结论参数分析结果可为今后儿童头部有限元模型的材料选取提供参考依据,进而提升模型在预测临床上无法通过脑CT影像确诊的脑震荡等脑损伤时的准确性。     

Brain Injury Prediction: Assessing the Combined Probability of Concussion Using Linear and Rotational Head Acceleration

Recent research has suggested possible long term effects due to repetitive concussions, highlighting the importance of developing methods to accurately quantify concussion risk. This study introduces a new injury metric, the combined probability of concussion, which computes the overall risk of concussion based on the peak linear and rotational accelerations experienced by the head during impact. The combined probability of concussion is unique in that it determines the likelihood of sustaining a concussion for a given impact, regardless of whether the injury would be reported or not. The risk curve was derived from data collected from instrumented football players (63,011 impacts including 37 concussions), which was adjusted to account for the underreporting of concussion. The predictive capability of this new metric is compared to that of single biomechanical parameters. The capabilities of these parameters to accurately predict concussion incidence were evaluated using two separate datasets: the Head Impact Telemetry System (HITS) data and National Football League (NFL) data collected from impact reconstructions using dummies (58 impacts including 25 concussions). Receiver operating characteristic curves were generated, and all parameters were significantly better at predicting injury than random guessing. The combined probability of concussion had the greatest area under the curve for all datasets. In the HITS dataset, the combined probability of concussion and linear acceleration were significantly better predictors of concussion than rotational acceleration alone, but not different from each other. In the NFL dataset, there were no significant differences between parameters. The combined probability of concussion is a valuable method to assess concussion risk in a laboratory setting for evaluating product safety.     

Head impact exposure in youth football

The head impact exposure for athletes involved in football at the college and high school levels has been well documented; however, the head impact exposure of the youth population involved with football has yet to be investigated, despite its dramatically larger population. The objective of this study was to investigate the head impact exposure in youth football. Impacts were monitored using a custom 12 accelerometer array equipped inside the helmets of seven players aged 7–8 years old during each game and practice for an entire season. A total of 748 impacts were collected from the 7 participating players during the season, with an average of 107 impacts per player. Linear accelerations ranged from 10 to 100 g, and the rotational accelerations ranged from 52 to 7694 rad/s². The majority of the high level impacts occurred during practices, with 29 of the 38 impacts above 40 g occurring in practices. Although less frequent, youth football can produce high head accelerations in the range of concussion causing impacts measured in adults. In order to minimize these most severe head impacts, youth football practices should be modified to eliminate high impact drills that do not replicate the game situations.     

Head Impact Exposure in Youth Football: Elementary School Ages 9–12 Years and the Effect of Practice Structure

Head impact exposure in youth football has not been well-documented, despite children under the age of 14 accounting for 70% of all football players in the United States. The objective of this study was to quantify the head impact exposure of youth football players, age 9–12, for all practices and games over the course of single season. A total of 50 players (age = 11.0 ± 1.1 years) on three teams were equipped with helmet mounted accelerometer arrays, which monitored each impact players sustained during practices and games. During the season, 11,978 impacts were recorded for this age group. Players averaged 240 ± 147 impacts for the season with linear and rotational 95th percentile magnitudes of 43 ± 7 g and 2034 ± 361 rad/s². Overall, practice and game sessions involved similar impact frequencies and magnitudes. One of the three teams however, had substantially fewer impacts per practice and lower 95th percentile magnitudes in practices due to a concerted effort to limit contact in practices. The same team also participated in fewer practices, further reducing the number of impacts each player experienced in practice. Head impact exposures in games showed no statistical difference. While the acceleration magnitudes among 9–12 year old players tended to be lower than those reported for older players, some recorded high magnitude impacts were similar to those seen at the high school and college level. Head impact exposure in youth football may be appreciably reduced by limiting contact in practices. Further research is required to assess whether such a reduction in head impact exposure will result in a reduction in concussion incidence.     

Intracranial Pressure Response to Non-Penetrating Ballistic Impact: An Experimental Study Using a Pig Physical Head Model and Live Pigs

This study was conducted to characterize the intracranial pressure response to non-penetrating ballistic impact using a "scalp-skull-brain" pig physical head model and live pigs. Forty-eight ballistic tests targeting the physical head model and anesthetized pigs protected by aramid plates were conducted with standard 9 mm bullets at low (279-297 m/s), moderate (350-372 m/s), and high (409-436 m/s) velocities. Intracranial pressure responses were recorded with pressure sensors embedded in similar brain locations in the physical head model and the anesthetized pigs. Three parameters of intracranial pressure were determined from the measured data: intracranial maximum pressure (P_max), intracranial maximum pressure impulse (PI_max), and the duration of the first positive phase (PPD). The intracranial pressure waves exhibited blast-like characteristics for both the physical model and l live pigs. Of all three parameters, P_max is most sensitive to impact velocity, with means of 126 kPa (219 kPa), 178 kPa (474 kPa), and 241 kPa (751 kPa) for the physical model (live pigs) for low, moderate, and high impact velocities, respectively. The mean PPD becomes increasingly short as the impact velocity increases, whereas PI_max shows the opposite trend. Although the pressure parameters of the physical model were much lower than those of the live pigs, good correlations between the physical model and the live pigs for the three pressure parameters, especially P_max, were found using linear regression. This investigation suggests that P_max is a preferred parameter for predicting the severity of the brain injury resulting from behind armor blunt trauma (BABT).