Modeling and simulation of brain herniation caused by subdural hematoma using finite-element method

¹ Institute of Biomedical Engineering, National Taiwan University, Taiwan
² Institute of Clinical Neuroscience, National Taiwan University Hospital, Taiwan
³ Graduate Institute of Medical Informatics, Taipei Medical University, Taiwan
⁴ Institute of Biomedical Engineering, National Yang-Ming University, Taiwan
⁵ Department of Neurosurgery, Taipei Hospital, Taiwan
⁶ Department of Neurosurgery, Taipei City Hospital, Taiwan
⁷ Biomedical Engineering Office, Taipei City Hospital, Taiwan

^a Corresponding author: d95548001@ntu.edu.tw

Abstract

Brain shift and herniation are important signs of increased intracranial pressure (ICP) caused by hematomas or other types of intracranial mass. We propose a novel finite-element model that can be deformed in response to increased ICP. The half sphere model of the brain is partially divided into two compartments by the intact mid-sagittal plane, allowing subfalcine herniation. A 40 mm circle in the center of its equatorial plane allows transtentorial herniation. We perform a single load step, structural static analysis, simulating a left-sided subdural hematoma (SDH) compressing the cerebral hemispheres from the outer surface of the left hemisphere. Subfalcine and transtentorial brain herniations are reproduced and visualized. The Poisson’s ratio represents the tightness of the brain and the pressure load represents the ICP. There is a linear relationship between maximal deformation and the pressure load. The maximal deformation at the basal circumference and that at the basal midline closely resembles the maximal thickness of the SDH and the midline shift. We have developed a simple finite-element model that can simulate brain shift and herniation caused by pressure loads exerted on its surface by a mass. The experimental results correlate well with clinical observation on patients with acute and chronic SDH.