Near-Infrared Laser Spectroscopy as a Screening Tool for Detecting Hematoma in Patients with Head Trauma

Abstract

Introduction:Among imaging techniques, computed tomography (CT) is a reliable method for detecting intracranial hematomas in patients with head trauma, but it is not generally available in special circumstances like prehospital situations and harsh conditions such as those following an earthquake.Objective:The objective of this study is to determine if near-infrared spectroscopy (NIRS) is useful for performing CT scans on patients with closed head trauma that present to medical centers that do not have the ability to perform a CT scan or in prehospital or harsh situations. Near-infrared spectroscopy and CT scan were compared according to sensitivity and specificity.Methods:This was an observational, prospective study. One hundred forty-eight patients admitted to Rasool Akram General Hospital in Tehran, Iran with head injuries during a one-month period were studied using NIRS and CT. The observational, prospective study was conducted and sensitivity, specificity, positive and negative predictive values of NIRS were calculated. Chi-square and Kappa analysis was performed, and a p-value <0.05 was considered significant.Results:According to the CT scan findings, 54 (36.5%) of the patients developed intracranial hematoma. The NIRS examination showed that 69 patients (46.6%) might have intracranial hematoma. The number of true negatives was 73 and the number of false negatives was six patients. The sensitivity and specificity of NIRS examination was 88.9% and 77.7%, respectively.Conclusions:This study speculates that NIRS may be a useful screening tool to detect intracranial hematoma. This capability could be useful in special situations like in a deprived area, medical centers without CT scan capabilities, prehospital situations, and in harsh conditions like those after an earthquake or other disasters that causes increased numbers of victims with closed head trauma.

Non‐invasive diagnosis and treatment strategies for traumatic brain injury: an update

“…It can also detect and localize intracranial hematomas (Gopinath, Robertson, Grossman, & Chance, ) as well as provide continuous, non‐invasive measurement of cerebral hemodynamic and metabolic parameters over multiple regions of interest. Ghalenoui et al () for instance, studied 142 patients with closed‐head injuries. The sensitivity and the specificity of an NIRS for detecting intracranial hematomas was 88.9% and 77.7%, respectively.…”

Non-invasive optical imaging of stroke

“…Although routinely performed in most 'Western' countries, CT/MRI may not be available to all acute stroke patients worldwide. Hence, less cost-intensive techniques-including optical imaging (OI)-have been probed as a screening tool for intracerebral haemorrhage [15]. However, the most decisive differential diagnosis, hypertensive intracerebral haemorrhage, is typically located in the deeper parts of the brain [16], and is thus not directly accessible to non-invasive OI.…”

Clinical application of near-infrared spectroscopy in patients with traumatic brain injury: a review of the progress of the field

“…In 2008, Ghalenoui et al 7 published a prospective observational study in which they evaluated 148 patients admitted to a hospital in Iran with head injuries with both CT and NIRS. They found that NIRS found 46.6% of the admitted patients to possibly have intracranial hematoma, while CT scan determined that the true number of patients with intracranial hematoma was actually 36.5%.…”