Analysis of a Severe Head Injury in World Cup Alpine Skiing

Traumatic brain injury (TBI) is the leading cause of death in alpine skiing. It has been found that helmet use can reduce the incidence of head injuries between 15% and 60%. However, knowledge on optimal helmet performance criteria in World Cup alpine skiing is currently limited owing to the lack of biomechanical data from real crash situations. Purpose: This study aimed to estimate impact velocities in a severe TBI case in World Cup alpine skiing. Methods: Video sequences from a TBI case in World Cup alpine skiing were analyzed using a model-based image matching technique. Video sequences from four camera views were obtained in full high-definition (1080p) format. A three-dimensional model of the course was built based on accurate measurements of piste landmarks and matched to the background video footage using the animation software Poser 4. A trunk-neck-head model was used for tracking the skier's trajectory. Results: Immediately before head impact, the downward velocity component was estimated to be 8 m.s(-1). After impact, the upward velocity was 3 m.s(-1), whereas the velocity parallel to the slope surface was reduced from 33 m.s(-1) to 22 m.s(-1). The frontal plane angular velocity of the head changed from 80 radIsj1 left tilt immediately before impact to 20 rad.s(-1) right tilt immediately after impact. Conclusions: A unique combination of high-definition video footage and accurate measurements of landmarks in the slope made possible a high-quality analysis of head impact velocity in a severe TBI case. The estimates can provide crucial information on how to prevent TBI through helmet performance criteria and design.