OBJECTIVES AND METHODS: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine. Firstly, as a triage tool both in hospital and prehospital settings by doctors, nurses or paramedics as determined by its negative predictive value (NPV). Secondly, as a diagnostic aid as determined by its positive predictive value (PPV). The aim of this systematic review and meta-analysis is therefore to interrogate the current literature on NIRS in detecting intracranial haematomas. RESULTS: NIRS technology has a cross-study sensitivity of 78%, specificity of 90%, PPV of 77%, and a NPV of 90%, which does not meet current standards as a diagnostic/triage tool in the populations studied. Additionally, its use is limited to those without extracranial injuries and may also be complicated by long scan times. CONCLUSION: Larger and more heterogeneous studies are required for specifically evaluating NIRS performance in detecting intracranial lesions requiring emergency evacuation.
OBJECTIVES AND METHODS: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine. Firstly, as a triage tool both in hospital and prehospital settings by doctors, nurses or paramedics as determined by its negative predictive value (NPV). Secondly, as a diagnostic aid as determined by its positive predictive value (PPV). The aim of this systematic review and meta-analysis is therefore to interrogate the current literature on NIRS in detecting intracranial haematomas. RESULTS: NIRS technology has a cross-study sensitivity of 78%, specificity of 90%, PPV of 77%, and a NPV of 90%, which does not meet current standards as a diagnostic/triage tool in the populations studied. Additionally, its use is limited to those without extracranial injuries and may also be complicated by long scan times. CONCLUSION: Larger and more heterogeneous studies are required for specifically evaluating NIRS performance in detecting intracranial lesions requiring emergency evacuation.
Authors: Faith C Robertson; Sujit Gnanakumar; Claire Karekezi; Kerry Vaughan; Roxanna M Garcia; Bilal Abou El Ela Bourquin; Fahd Derkaoui Hassani; Alexander Alamri; Nesrine Mentri; Julius Höhne; Tsegazeab Laeke; Hosam Al-Jehani; Luis Rafael Moscote-Salazar; Ahmed Nasser Al-Ahmari; Nicolás Samprón; Martin N Stienen; Federico Nicolosi; Davi J Fontoura Solla; P David Adelson; Franco Servadei; Amro Al-Habib; Ignatius Esene; Angelos G Kolias Journal: World Neurosurg X Date: 2020-05-11
Authors: Sujit Gnanakumar; Bilal Abou El Ela Bourquin; Faith C Robertson; Davi J Fontoura Solla; Claire Karekezi; Kerry Vaughan; Roxanna M Garcia; Fahd Derkaoui Hassani; Alexander Alamri; Julius Höhne; Nesrine Mentri; Martin Stienen; Tsegazeab Laeke; Luis Rafael Moscote-Salazar; Ahmed Nasser Al-Ahmari; Hosam Al-Jehani; Federico Nicolosi; Nicolás Samprón; P David Adelson; Franco Servadei; Ignatius N Esene; Amro Al-Habib; Angelos G Kolias Journal: World Neurosurg X Date: 2020-05-19
Authors: Mark D Whiting; Bradley A Dengler; Carissa L Rodriguez; David Blodgett; Adam B Cohen; Adolph J Januszkiewicz; Todd E Rasmussen; David L Brody Journal: Front Neurol Date: 2020-10-30 Impact factor: 4.003