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2 results

  • Near-Infrared Laser Spectroscopy as a Screening Tool for Detecting Hematoma in Patients with Head Trauma

  • Hossein Ghalenoui, Hossein Saidi, Mazyar Azar, Seyyed Taha Yahyavi, Hamid Borghei Razavi, Mahmoudreza Khalatbari
  • Journal:
    Prehospital and Disaster Medicine / Volume 23 / Issue 6 / December 2008
    Published online by Cambridge University Press:
    28 June 2012, pp. 558-561
    Print publication:
    December 2008
  • Introduction:

    Among imaging techniques, computed tomography (CT) is a reliable method for detecting intracranial hematomas in patients with head trauma, but it is not generally available in special circumstances like prehospital situations and harsh conditions such as those following an earthquake.

    Objective:

    The objective of this study is to determine if near-infrared spectroscopy (NIRS) is useful for performing CT scans on patients with closed head trauma that present to medical centers that do not have the ability to perform a CT scan or in prehospital or harsh situations. Near-infrared spectroscopy and CT scan were compared according to sensitivity and specificity.

    Methods:

    This was an observational, prospective study. One hundred forty-eight patients admitted to Rasool Akram General Hospital in Tehran, Iran with head injuries during a one-month period were studied using NIRS and CT. The observational, prospective study was conducted and sensitivity, specificity, positive and negative predictive values of NIRS were calculated. Chi-square and Kappa analysis was performed, and a p-value <0.05 was considered significant.

    Results:

    According to the CT scan findings, 54 (36.5%) of the patients developed intracranial hematoma. The NIRS examination showed that 69 patients (46.6%) might have intracranial hematoma. The number of true negatives was 73 and the number of false negatives was six patients. The sensitivity and specificity of NIRS examination was 88.9% and 77.7%, respectively.

    Conclusions:

    This study speculates that NIRS may be a useful screening tool to detect intracranial hematoma. This capability could be useful in special situations like in a deprived area, medical centers without CT scan capabilities, prehospital situations, and in harsh conditions like those after an earthquake or other disasters that causes increased numbers of victims with closed head trauma.

  • 38 - ANTI-PHOSPHOLIPID ANTIBODY SYNDROME

  • from PART IV: - DISORDERS INVOLVING ABNORMAL COAGULATION
  • Edited by Louis R. Caplan, Julien Bogousslavsky
  • Book:
    Uncommon Causes of Stroke
    Published online:
    06 January 2010
    Print publication:
    09 October 2008, pp 263-274

  • Summary

    Neurofibromatosis (NF) is an autosomal dominant disorder encompassing several distinct genetic defects with overlapping clinical features. This chapter focuses on the main genetic, clinical, pathological, and radiological features of neurofibromatosis type 1 (NF1). The cerebrovascular manifestations of NF1 include cerebral ischemia, intracranial hematoma, and subarachnoidal hemorrhage. Recurrent strokes can occur in the same or in different territories. Every large or medium-sized artery can be affected, and some patients have multiple stenoses of intracranial vessels combined with stenoses or occlusion of extracranial vessel. Hemispheric territorial infarction is a common stroke manifestation. Ocular involvement may present with retinal ischemia or global ocular ischemia. Angiography, time-of-flight magnetic resonance angiography (TOF-MRA) and Color duplex and spectral Doppler ultrasonography are useful diagnostic modalities for revealing the vascular complications of NF1. Neurosurgical revascularization in patients with moyamoya syndrome has been shown to reduce the risk of first-ever and recurrent stroke and transient ischemic attack (TIA).