Head and Brain Injuries

A medical legal visualization case study

Jane Doe had a car accident which resulted in her head bumping onto the dashboard and breaking her zygoma bone. She later had a surgery to correct the position of the bone. However, years later, she was diagnosed with traumatic brain injury, which is potentially a long-term harm from the accident. Demonstrative evidence is needed in court for her attorney to present the case for compensation.

 

Jane's attorney brought all the medical records and CT/MRI scans to ASMA Studios (ASMA - Alex Ho, Sherry An, Mimi Guo and Abeeshan Selvabaskaran) for visualization solutions. ASMA Studios proposed four static exhibits to accurately show what Jane has gone through – her mechanism of injury,  a trauma illustration including fractures and soft tissue injury, an illustration on the surgical process, and an exhibit showing her brain injury and event timeline. 

Tripod fracture - for portfolio-step7-02.png
MOI-Final_final .png
Fracture-final-02.png
Surgery-Final-01.png
TBI-Final-01.png

Faculty advisor

Stephen Mader

Medium/Software

3D slicer, ZBrush, Procreate, and Adobe Illustrator

Final presentation format

Four horizontal panels for screen presentation

Primary audience

Demonstrative evidence for jury in court

Work Process

From medical records to visual plans

After digesting all the medical information, and reconstructing 3D skull from CT scans, we selected and drafted up information that will be presented on each panel.

  • Mechanism of Injury by Sherry An

  • Trauma Illustration by Mimi Guo

  • Surgical Illustration by Abeeshan Selvabaskaran

  • Brain Injury and Timeline by Alex Ho

Tripod fracture - for portfolio-step1-01.png

Reference

  1. Agur, A., & Dalley, A. F. (2019). Moore’s Essential Clinical Anatomy (6th ed.). Wolters Kluwer.

  2. Balakrishnan, K., Ebenezer, V., Dakir, A., Kumar, S. K., & Prakash, D. (2015). Management of tripod fractures (zygomaticomaxillary complex) 1 point and 2 point fixations: A 5-year review. Journal of Pharmacy & Bioallied Sciences, 7(Suppl 1), S242. https://doi.org/10.4103/0975-7406.155937

  3. Cornelius, C.-P., Gellrich, N., Hillerup, S., Lisi,ptp, L., & Schubert, W. (n.d.). Indirect approaches to the zygomatic arch (temporal and transoral approaches). AO Foundation Surgery Reference. Retrieved October 24, 2021, from https://surgeryreference.aofoundation.org/cmf/trauma/midface/approach/indirect-approaches-to-the-zygomatic-arch-temporal-and-transoral-approaches#temporal-gillies-approach-skin-incision

  4. Cross-sectional anatomy of the brain. (2021, September 13). IMAIOS. Retrieved October 26, 2021, from https://www.imaios.com/en/e-Anatomy/Brain/Brain-MRI-in-axial-slices

  5. Debowski, M. (2018, July 14). Brain lobes - annotated MRI | Radiology Case Radiopaedia.org. Radiopedia. Retrieved October 27, 2021, from https://radiopaedia.org/cases/brain-lobes-annotated-mri-1

  6. Douglas, D. B., Ro, T., Toffoli, T., Krawchuk, B., Muldermans, J., Gullo, J., Dulberger, A., Anderson, A. E., Douglas, P. K., & Wintermark, M. (2019). Neuroimaging of Traumatic Brain Injury. Medical Sciences, 7(1), 2. https://doi.org/10.3390/MEDSCI7010002

  7. Jenkins, A., Hadley, M. D. M., Teasdale, G., Macpherson, P., & Rowan, J. O. (1986). BRAIN LESIONS DETECTED BY MAGNETIC RESONANCE IMAGING IN MILD AND SEVERE HEAD INJURIES. The Lancet, 328(8504), 445–446. https://doi.org/10.1016/S0140-6736(86)92145-8

  8. Lee, B., & Newberg, A. (2005). Neuroimaging in Traumatic Brain Imaging. NeuroRx, 2(2), 372. https://doi.org/10.1602/NEURORX.2.2.372

  9. Levin, H. S., Amparo, E., Eisenberg, H. M., Williams, D. H., High, W. M., McArdle, C. B., & Weiner, R. L. (1987). Magnetic resonance imaging and computerized tomography in relation to the neurobehavioral sequelae of mild and moderate head injuries. Journal of Neurosurgery, 66(5), 706–713. https://doi.org/10.3171/JNS.1987.66.5.0706

  10. Meythaler, J. M., Peduzzi, J. D., Eleftheriou, E., & Novack, T. A. (2001). Current concepts: Diffuse axonal injury–associated traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 82(10), 1461–1471. https://doi.org/10.1053/APMR.2001.25137

  11. Narayana, P. A. (2017). White matter changes in patients with mild traumatic brain injury: MRI perspective. Concussion, 2(2), CNC35. https://doi.org/10.2217/CNC-2016-0028

  12. Otake, S., Taoka, T., Maeda, M., & Yuh, W. T. (2018). A guide to identification and selection of axial planes in magnetic resonance imaging of the brain: https://Doi-Org.Myaccess.Library.Utoronto.ca/10.1177/1971400918769911, 31(4), 336–344. https://doi.org/10.1177/1971400918769911

 

Additional references

  1. Direct CT and MRI scans from Vanessa Williams’ diagnosis

  2. 3D Reconstructed models from case CT scans