Noninvasive Monitoring of Traumatic Intracranial Hematoma Progression Using the Infrascanner: Preliminary Experience

TL;DR

This study explores using the Infrascanner device to noninvasively monitor changes in traumatic brain hemorrhages over time.

Contribution

The study provides preliminary evidence on the practicality of using the Infrascanner for serial monitoring of intracranial hematoma progression.

Findings

Hourly infrascans were successfully performed in 88% of attempts.

Technical issues and patient logistics were the main barriers to consistent scanning.

The study was underpowered to determine the device's ability to detect hematoma expansion.

Abstract

Early detection of intracranial hematoma (ICH) expansion is critical to improving outcomes in patients with traumatic brain injuries (TBIs). The Infrascanner 2000 (InfraScan Inc) is a US Food and Drug Administration–cleared device capable of detecting ICHs. We report our preliminary experience of conducting a prospective evaluation of serial infrascans to evaluate the diagnostic performance of the device for monitoring changes in ICH size.

A single-center prospective observational study was conducted. We included patients with traumatic ICHs detected on admission computed tomography (CT) scanning, and conducted hourly infrascans until a second CT scan had been performed. We evaluated the practicability of enrollment, conducting hourly infrascans, and the diagnostic performance of the device.

We approached 134 patients, or their legally authorized representatives, and enrolled 62 (46%). Most index hematomas were small (median, 2.5 mL, IQR, 0.6-7.0 mL), and 23 experienced enlargement. Hourly infrascan assessments were performed successfully in the majority of patients (300 of 340 scans, 88%). The most common reasons for scans not being performed, or not performed on time, were technical issues with the devices (17 scans, 40%), the presence of dressings and bandages (2 scans, 5%), and patients being taken for other investigations or treatment (12 scans, 31%). Given the sample size, the small size of enrolled patients’ ICHs, and the low proportion that experienced enlargement, it was not possible to demonstrate the ability of the Infrascanner to detect expansion.

This preliminary study confirms the practicability of conducting a prospective evaluation of the Infrascanner for the purpose of serially monitoring the size of ICHs in trauma patients.

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