Study of near infrared technology for intracranial hematoma detection

Abstract

Although intracranial hematoma detection only requires the continuous wave technique of near infrared spectroscopy (NIRS), previous studies have shown that there are still some problems in obtaining very accurate, reliable hematoma detection. Several of the most important limitations of NIR technology for hematoma detection such as the dynamic range of detection, hair absorption, optical contact, layered structure of the head, and depth of detection are reported in this article. A pulsed light source of variable intensity was designed and studied in order to overcome hair absorption and to increase the dynamic range and depth of detection. An adaptive elastic optical probe was made to improve the optical contact and decrease contact noise. A new microcontroller operated portable hematoma detector was developed. Due to the layered structure of the human head, simulation on a layered medium was analyzed experimentally. Model inhomogeneity tests and animal hematoma tests showed the effectiveness of the improved hematoma detector for intracranial hematoma detection.

NIR light propagation in a digital head model for traumatic brain injury (TBI)

“…3. These simulations support previous conclusions that there is an optical density difference between the uninjured brain and brain with a hematoma when the source-detector separation (S-D) is greater than 30 mm [36][37][38]. A 0.2 cc hematoma is slightly distinguishable as the diffuse reflectance profile begins to separate from the baseline "no hematoma" profile, and a 1.4 cc hematoma is definitely distinguishable from the baseline.…”

“…NIRS technology is also becoming smaller and more transportable for field use [34,35]. NIRS imaging has previously been developed for detecting intracranial hematomas based on the global optical density differences from a region on the head where there is a hematoma compared to a region where there is no hematoma [35][36][37][38][39][40][41]. One issue with this method is that in blunt trauma brain injury, when a patient is hit on one side of the head, a bruise or swelling appears on the side of the head that is hit and an intracranial hematoma may occur on the opposite side of the head, where the brain collides with the inside of the skull [42].…”

Near-Infrared Spectroscopy in the Monitoring of Adult Traumatic Brain Injury: A Review

“…Unfortunately, as with many other monitoring modalities within the field of brain injury medicine, there is very limited evidence to support the ability of NIRS to predict outcome after injury. Although frequently referred to in limited clinical investigations, [17][18][19][29][30][31][32][33][34][35][36][37] no substantial prospective investigation provides useful information regarding how NIRS parameters can be used to predict the eventual impact of a particular injury. This in particular provides an opportunity for very meaningful investigations to be undertaken in the future.…”

“…The presence of hematomas has such a profound effect on NIRS-derived rSO 2 readings that this perturbation itself has been exploited to demonstrate the presence of intracranial haematomas. 17,18 In addition, individuals who sustain a significant intracranial injury frequently have significant concurrent extracranial injuries. The systemic stress placed on an individual with such complex injuries has a profound effect on the quality of perfusion and oxygen consumption in the extracranial tissues (skin, scalp) and, therefore, the sophistication of differential algorithms employed by NIRS devices in such situations become all the more important.…”

The role of optical spectroscopy in epilepsy surgery in children

“…4,35,38,42,55 There are 3 optical spectroscopy types that are used frequently in biomedicine to monitor light-tissue interaction and therefore to perform in vivo tissue characterization: diffuse reflectance spectroscopy, 6,7,9,12,13,19,20,25,30,34,39,48,50,54,[56][57][58] fluorescence spectroscopy, 26,27 and Raman spectroscopy. 2,11,15,16,31,33 Each of these spectroscopy types targets a particular type of light-tissue interaction and a subset of biological molecules (Fig.…”