Follow-up in patients with subdural haematomas using near infrared spectroscopy (NIRS)

Secondary haemorrhage is an important cause of brain injury following initial therapy of subdural haematoma (SDH). Early identification and treatment of secondary haemorrhage improves neurologic outcome. Near infrared light at a wavelength of 760 nm shows a high absorption for haemoglobin. The difference in absorbance of light (ΔOD) at the wavelength of 760 nm between both hemispheres is measured to detect SDH. We have prospectively studied 20 patients with the CT diagnosis of SDH using near infrared spectroscopy (NIRS). Unilateral subdural haematomas were detected by NIRS in 15 out of 16 patients. Bilateral SDH were detected in 2 out of 3 patients. The median of ΔOD was reduced from initially 0.32 (0.05-0.85) to 0.1 (0.02-0.49) at hospital discharge. The complete resorption of the haematoma has been observed in 12 patients by NIRS. In 7 patients we still obtained pathologic values at discharge. The haematomas were not completely resolved, as proved by the CT scans prior to discharge. Our results showed repeated application of NIRS in patients with SDH help to document the clinical course after surgical treatment. Follow-up NIR evaluation of patients with SDH using NIRS may allow early treatment without time delay and a reduction of secondary brain injury as well as treatment costs.