Utility of a Near-Infrared Light Device (NIRD) in Detecting Subdural (SDH) and Epidural (EDH) Hematomas: An Effectiveness Trial Toward Using a NIRD for Neurosurgical Triaging in Low and Middle-Income Countries (LMICs)
A presentation at the 2019 American Association of Neurological Surgeons Annual Scientific Meeting
17-Apr-2019 3:00 PM EDT
Newswise — SAN DIEGO (April 17, 2019) — Winner of the Young Neurosurgeons Medical Student Abstract Award, Robert M. Gramer, presented his research, Utility of a Near-Infrared Light Device (NIRD) in Detecting Subdural (SDH) and Epidural (EDH) Hematomas: An Effectiveness Trial Toward Using a NIRD for Neurosurgical Triaging in Low and Middle-Income Countries (LMICs), during the 2019 American Association of Neurological Surgeons (AANS) Annual Scientific Meeting.
The World Health Organization estimates that more than 10 million people sustain traumatic brain injury (TBI) resulting in death or significant irreversible deficits annually, the majority occurring in low and middle income countries (LMICs). When subdural (SDH) and/or epidural (EDH) hematomas occur, the limited availability of computer tomography (CT) in these TBI-laden areas frequently impedes life-saving neurosurgical decompression. As neurosurgical infrastructure in LMICs continues to expand, a reliable, accessible, cost-effective solution to detect and localize such bleeds is imperative.
Included in this study were 500 consecutive patients presenting to Duke University Hospital Emergency Department with confirmed or suspected head trauma who received a head CT scan. Within thirty-minutes of the initial head CT scan, an examiner, blinded to the result, scanned each patient’s cranium with a near-infrared device (NIRD), interrogating frontal, temporal, parietal and occipital quadrants bilaterally. A difference in optical density >|.20| was considered a positive result, indicative of an intracranial bleed. For all NIRD-positive patients who underwent subsequent CT scans, serial NIRD measurements were collected.
These data collected demonstrates that a NIRD is both highly sensitive (94%) and specific (96%) in diagnosing extra-axial bleeds measuring >3.5 milliliters in volume. For all patients who required craniectomy or craniotomy, the device demonstrated 100 percent sensitivity. With these results, researchers intend to initiate a feasibility trial in Uganda using a NIRD to diagnose SDH/EDH.
Author Block: Robert M. Gramer, BS; Anthony Fuller, MD; Lexie Yang, PhD; Donna Niedzwiecki, PhD; Carmelo Graffagnino, MD; Beth Perry, BS; Michael Haglund, MD, PhD
Disclosure: The author reported no conflicts of interest.
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About the 2019 AANS Annual Scientific Meeting
Attended by neurosurgeons, neurosurgical residents, medical students, neuroscience nurses, clinical specialists, physician assistants, allied health professionals and other medical professionals, the AANS Annual Scientific Meeting is the largest gathering of neurosurgeons in the nation, with an emphasis on the field’s latest research and technological advances. The scientific presentations accepted for the 2019 event will represent cutting-edge examples of the incredible developments taking place within the field of neurosurgery. Find additional information about the 2019 AANS Annual Scientific Meeting and the meeting program here.
About the AANS
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 11,500 members worldwide. The AANS promotes the highest quality of patient care and advances the specialty of neurological surgery. Fellows of the AANS are board-certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons of Canada or the Mexican Council of Neurological Surgery, A.C. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spinal column, spinal cord, brain, nervous system and peripheral nerves.
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