Evaluation of the Stage of Hemorrhage Using Optical Diffuse Reflectance Spectroscopy: An In Vivo Study

Abstract

Intracerebral hemorrhage (ICH) is a common and often fatal subtype of stroke. Estimation of the stage of hemorrhage allows clinicians to know when the hemorrhage occurred, even in unconscious patients, enabling decisions to be made about the optimal management and treatment strategy. After ICH, oxidative denaturation of the hemoglobin progresses, and deoxyhemoglobin is gradually converted to methemoglobin. MRI has been used to estimate the stage of hemorrhage by evaluating the status of hemoglobin. However, there is currently no bedside device that can be used for the measurement of hemoglobin derivatives in patients with hematomas. The aim of the present study was to investigate the validity of using optical diffuse reflectance spectroscopy (ODRS) for bedside evaluation of the stage of hemorrhage. An ICH model was generated in adult Sprague-Dawley male rats by stereotactically injecting 50 μl of autologous blood into the right caudate nucleus. To analyze the hemoglobin derivatives in the hematomas, ODRS measurement was performed for the rats in vivo. In all rats, we found increased absorption at around 630 nm, which indicated the formation of methemoglobin. In conclusion, the results of the present study suggest that ODRS allows clinicians to more easily evaluate the stage of hemorrhage at the patient's bedside.

Medical applications of reflectance spectroscopy in the diffusive and sub-diffusive regimes

“…Furthermore, DRS is increasingly being used for medical diagnosis and intra-operative analysis of surgical resection margins. For example, DRS has been applied to the diagnosis of liver metastasis, 57 assessment of the degree of hepatic steatosis, 57 evaluation of peripheral arterial occlusive disease, 58 early detection and diagnosis of renal cell cancers, 59 estimation of stage of intracerebral hemorrhage (ICH), 60 detection of atherosclerotic plaque, 61 etc. In the following section, we focus on the clinical applications of DRS to cancer, liver disease, brain disease, cardiac disease, renal disease, and others.…”

Heme induces autophagic cell death via ER stress in neuron

“…During ICH, large numbers of erythrocytes are released into the extracellular spaces in the brain. Following erythrocytes are lysed, extracellular hemoglobin is rapidly oxidized into methemoglobin and releases heme [4,5]. The free heme binds to lipids intercalating into cell membranes, leading to neuron damage [6,7,8].…”