Early detection of delayed traumatic intracranial hematomas using near- infrared spectroscopy

S. P. Gopinath, C. S. Robertson, C. F. Contant, R. K. Narayan, Robert G. Grossman, B. Chance

Research output: Contribution to journalArticle

116 Scopus citations

Abstract

Delayed intracranial hematomas are an important treatable cause of secondary brain injury in patients with head trauma. Early identification and treatment of these lesions, which appear or enlarge after the initial computerized tomography (CT) scan, may improve neurological outcome. Serial examinations using near-infrared spectroscopy (NIRS) to detect the development of delayed hematomas were performed in 167 patients. The difference in absorbance of light (ΔOD) at 760 nm between the normal and the hematoma side was measured serially during the first 3 days after injury. Twenty-seven (16%) of the patients developed a type of late hematoma: intracerebral hematoma in eight, extracerebral hematoma in six, and postoperative hematoma in 13 patients. Eighteen of the delayed hematomas caused significant mass effect and required surgical evacuation. The hematomas appeared between 2 and 72 hours after admission. In 24 of the 27 patients, a significant increase (> 0.3) in the ΔOD occurred prior to an increase in intracranial pressure, a change in the neurological examination, or a change on CT scan. A favorable outcome occurred in 67% of the patients with delayed hematomas, which suggests that early diagnosis using NIRS may allow early treatment and reduce secondary injury caused by delayed hematomas.

Original languageEnglish (US)
Pages (from-to)438-444
Number of pages7
JournalJournal of Neurosurgery
Volume83
Issue number3
DOIs
StatePublished - 1995

Keywords

  • delayed traumatic hematoma
  • epidural hematoma
  • head injury
  • intracerebral hematoma
  • near-infrared spectroscopy
  • subdural hematoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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