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This is how hidden skull injuries are detected

Published Apr 11, 2011

It has taken 20 man-years to develop the new tool, which can detect hidden skull injuries. But it is time well invested. Each year, about 50,000 patients with trauma to the head or to the neck are taken care of, and there are several different types of injuries that either show diffuse symptoms or are difficult to analyze with current diagnostic methods. Using the new tool, it will now be faster to determine what sort of treatment is needed, and the decision taken will be better grounded and can therefore provide more quality care.

Peter Halldin
Peter Halldin, researcher at the Department of Neuronics at the School of Technology and Health KTH

Peter Halldin, a researcher at the Department of Neuronics at the School of Technology and Health KTH, together with a number of other researchers, has developed models that make it very clear for doctors how a man's neck, skull, muscles and brain are affected by collisions with different objects. The sequence of events leading up to the accident with the model's help can namely, visualize in detail different perspectives and cross-sections.

"So far, doctors have only been able to rely on the patient's story and x-rays in order to make the right decision. Through a simulation of the trauma, the doctor may obtain additional pieces of information so that the appropriate treatment can be chosen," says Peter Halldin.

With the help of the model, these accidents can illustrate the sequence of events leading up to the injury over a period of milliseconds as the injury is taking place. This provides the history leading up to the injury and can complement existing diagnostic methods used today such as still images from X-ray images using CT or MRI.

The project and the tool with models and simulation software is called Visualization through image and simulation, VIS. Those involved from the School of Technology and Health, KTH include, in addition to Peter Halldin, Hans von Holst, Johnson Ho, Svein Kleiven and Madelen Fahlstedt. VIS is divided into two parts. First of all, VISed which is intended to be used in the training of medical personnel, and VISweb which is an encyclopaedia where users can interactively choose the direction and magnitude of the acceleration as well as the area and the force involved when an injury is occurring. Quite simply, it's like an atlas of a range of possible accident scenarios.

"The VIS project is an excellent aid in the training of doctors because the damage can be easily simulated, and understanding will be enhanced when simulations are presented in a pedagogical fashion. Moreover, the simulations are more attractive to look at than the grey X-ray images," says Madelen Fahlstedt.

Madelen Fahlstedt
Madelen Fahlstedt, one of the scientists participating in the VIS project

It therefore becomes clear that VIS is more versatile than mere doctors alone. For example, the tool can prove very useful for the automotive industry, an industry that is in need of better testing methods to develop safer cars. Peter Halldin and his colleagues have already been in contact with several manufacturers.

"We have already arranged to cooperate with Saab and Volvo, and also with the U.S. Army for their camera-equipped helmets and the subsequent load on the neck the soldier has to bear when carrying this extra equipment," says Peter Halldin.

He adds that VIS is also a great tool for experts who work at insurance companies.

"It is not always the case that those with whiplash injuries receive a correct diagnosis and the entitlement to compensation from insurance companies. In fact, one person on average every week rings us up who would like some help with this," says Peter Halldin.

Madelen Fahlstedt adds that VIS is also important for the patient because he or she can process the accident mentally by seeing what actually happened.

VIS has already been exposed to hard clinical tests. The severe accident that occurred during the Swedish Championships in motocross in 2004 when two riders collided on Malmabanan (the Malma track) in Västerås has been simulated. Research colleague Svein Kleiven who performed this study found the same bleeding in the brain in the simulation as in reality.

"75 per cent of research time has been spent on verifying the tool and the models, in terms of real events," says Peter Halldin.

When Peter Halldin, Madelen Fahlstedt and their colleagues are ready with VIS, it is thought that the simulation of an accident should go very quickly. Under one hour is the objective.

"VIS is not a diagnostic tool, but rather a support tool to help doctors make a decision - this is because it takes a while to introduce changes in the health care system. That is, how doctors work, and which tools they work with," says Peter Halldin.

Peter Halldin and his colleagues hope however, that things happen quickly and that VIS can become an active part of the physician's everyday life as soon as possible.

For more information, contact Madelen Fahlstedt at 08-790 48 76 / or Peter Halldin at 073-985 00 61 /


Project: VIS, Visualization through image and simulation

Financing: KK stiftelsen, SEK 4.1 million

Other partners in the project:

  • Department of Clinical Science, Intervention and Technology, Department of Orthopaedic Surgery (CLINTEC), Karolinska Institutet.
  • Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet.
  • Sensegraphics AB

Peter Larsson