Application of optical methods in the monitoring of traumatic brain injury: A review

Abstract

We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following search terms: "traumatic brain injury," "head injury," or "head trauma," and "optical methods," "NIRS," "near-infrared spectroscopy," "cerebral oxygenation," or "cerebral oximetry." Original reports concerning human subjects published from January 1980 to June 2015 in English were analyzed. Fifty-four studies met our inclusion criteria. Optical methods have been tested for detection of intracranial lesions, monitoring brain oxygenation, assessment of brain perfusion, and evaluation of cerebral autoregulation or intracellular metabolic processes in the brain. Some studies have also examined the applicability of optical methods during the recovery phase of traumatic brain injury . The limitations of currently available optical methods and promising directions of future development are described in this review. Considering the outstanding technical challenges, the limited number of patients studied, and the mixed results and opinions gathered from other reviews on this subject, we believe that optical methods must remain primarily research tools for the present. More studies are needed to gain confidence in the use of these techniques for neuromonitoring of traumatic brain injury patients.

Keywords: Cerebral oximetry; near-infrared spectroscopy; neuromonitoring; optical methods; traumatic brain injury.

Figure 1.

NIRS data acquisition modes and obtained physiologically useful parameters. ΔcHb: changes in concentrations of deoxyhemoglobin; ΔcHbO₂: changes in concentrations of oxyhemoglobin; ΔcHbT: changes in concentrations of total hemoglobin; cHb: absolute concentrations of deoxyhemoglobin; cHbO₂: absolute concentrations of oxyhemoglobin; cHbT: absolute concentrations of total hemoglobin; rSO₂: regional cerebral tissue oxygen saturation.