Abusive Head Trauma: finite element analysis of shaking and impact inflicted to a PIPER child body model

Abusive Head Trauma (AHT) is a constellation of brain injuries caused by the directed application of the shaking movement to a neonate or young child, inducing an uncontrolled movement of the head and resulting in high degree of mortality and morbidity injury to the head and neck. In fact, violently shaking a baby leads to clinical manifestations going from seizures to cardiopulmonary arrest. The main injuries experienced are subdural hematoma, retinal hemorrhage and encephalopathy, but also fractures and spine injury. AHT comprehends injuries that result from both shaking and direct impact to the head, either by a direct blow to the head or by causing the head to collide with another object or surface. The aim of the present thesis’s work is to simulate the AHT phenomena thanks to the Finite Element Method (FEM) and using the PIPER child body model, in order to evaluate the potential risks for child’s health. In particular, after an excursus on the state of the art and AHT damage criteria, this work will discuss shaking cases with impact focusing on different amplitudes of the shaking curves. The impact surface is represented by the combination of a pillow and a mattress, to replicate that the child is shaken near a bed, a possible common situation. The purpose is to assess the risk for child in case of impact against an elastic surface, even analysing the cases with different amplitudes and comparing the case of shaking with impact with the case of shaking without impact to have a more complete picture of the AHT phenomenon.