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Introduction: We sought to validate a handheld, near-infrared spectroscopy (NIRS) device for detecting intracranial hematomas in children with head injury.Methods: Eligible patients were those <18 years old who were admitted to the emergency department at three academic children’s hospitals with head trauma and who received a clinically indicated head computed tomography (HCT). Measurements were obtained by a blinded operator in bilateral frontal, temporal, parietal, and occipital regions. Qualifying hematomas were a priori determined to be within the brain scanner’s detection limits of >3.5 milliliters in volume and <2.5 centimeters from the surface of the brain. The device’s measurements were positive if the difference in optical density between hemispheres was >0.2 on three successive scans. We calculated diagnostic performance measures with corresponding exact two-sided 95% Clopper-Pearson confidence intervals (CI). Hypothesis test evaluated whether predictive performance exceeded chance agreement (predictive Youden’s index > 0).Results: A total of 464 patients were enrolled and 344 met inclusion for primary data analysis: 10.5% (36/344) had evidence of a hematoma on HCT, and 4.7% (16/344) had qualifying hematomas. The handheld brain scanner demonstrated a sensitivity of 58.3% (21/36) and specificity of 67.9% (209/308) for hematomas of any size. For qualifying hematomas the scanner was designed to detect, sensitivity was 81% (13/16) and specificity was 67.4% (221/328). Predictive performance exceeded chance agreement with a predictive Youden’s index of 0.11 (95% CI, 0.10 – 0.15; P < 0.001) for all hematomas, and 0.09 (95% CI, 0.08 – 0.12; P < 0.001) for qualifying hematomas.Conclusion: The handheld brain scanner can non-invasively detect a subset of intracranial hematomas in children and may serve an adjunctive role to head-injury neuroimaging decision rules that predict the risk of clinically significant intracranial pathology after head tr

Introduction: We sought to validate a handheld, near-infrared spectroscopy (NIRS) device for detecting intracranial hematomas in children with head injury.Methods: Eligible patients were those <18 years old who were admitted to the emergency department at three academic children’s hospitals with head trauma and who received a clinically indicated head computed tomography (HCT). Measurements were obtained by a blinded operator in bilateral frontal, temporal, parietal, and occipital regions. Qualifying hematomas were a priori determined to be within the brain scanner’s detection limits of >3.5 milliliters in volume and <2.5 centimeters from the surface of the brain. The device’s measurements were positive if the difference in optical density between hemispheres was >0.2 on three successive scans. We calculated diagnostic performance measures with corresponding exact two-sided 95% Clopper-Pearson confidence intervals (CI). Hypothesis test evaluated whether predictive performance exceeded chance agreement (predictive Youden’s index > 0).Results: A total of 464 patients were enrolled and 344 met inclusion for primary data analysis: 10.5% (36/344) had evidence of a hematoma on HCT, and 4.7% (16/344) had qualifying hematomas. The handheld brain scanner demonstrated a sensitivity of 58.3% (21/36) and specificity of 67.9% (209/308) for hematomas of any size. For qualifying hematomas the scanner was designed to detect, sensitivity was 81% (13/16) and specificity was 67.4% (221/328). Predictive performance exceeded chance agreement with a predictive Youden’s index of 0.11 (95% CI, 0.10 – 0.15; P < 0.001) for all hematomas, and 0.09 (95% CI, 0.08 – 0.12; P < 0.001) for qualifying hematomas.Conclusion: The handheld brain scanner can non-invasively detect a subset of intracranial hematomas in children and may serve an adjunctive role to head-injury neuroimaging decision rules that predict the risk of clinically significant intracranial pathology after head tr

type:text, A report is presented on two cases of chronic subdural hematoma which occurred after craniotomy, removal of the hematoma and external decompression for traumatic intracranial hematoma. As for the pathogenesis of chronic subdural hematoma of these two cases, these chronic subdural hematomas were considered to have originated from the subdural collection of mixed fluid of cerebrospinal fluid and blood caused by tearing of the arachnoid on head injury or craniotomy in the space between the brain and dural plasty. Opening and irrigating the hematoma cavity proved adequate as treatment at cranioplasty.

A report is presented on two cases of chronic subdural hematoma which occurred after craniotomy, removal of the hematoma and external decompression for traumatic intracranial hematoma. As for the pathogenesis of chronic subdural hematoma of these two cases, these chronic subdural hematomas were considered to have originated from the subdural collection of mixed fluid of cerebrospinal fluid and blood caused by tearing of the arachnoid on head injury or craniotomy in the space between the brain and dural plasty. Opening and irrigating the hematoma cavity proved adequate as treatment at cranioplasty.

A report is presented on two cases of chronic subdural hematoma which occurred after craniotomy, removal of the hematoma and external decompression for traumatic intracranial hematoma. As for the pathogenesis of chronic subdural hematoma of these two cases, these chronic subdural hematomas were considered to have originated from the subdural collection of mixed fluid of cerebrospinal fluid and blood caused by tearing of the arachnoid on head injury or craniotomy in the space between the brain and dural plasty. Opening and irrigating the hematoma cavity proved adequate as treatment at cranioplasty.

A report is presented on two cases of chronic subdural hematoma which occurred after craniotomy, removal of the hematoma and external decompression for traumatic intracranial hematoma. As for the pathogenesis of chronic subdural hematoma of these two cases, these chronic subdural hematomas were considered to have originated from the subdural collection of mixed fluid of cerebrospinal fluid and blood caused by tearing of the arachnoid on head injury or craniotomy in the space between the brain and dural plasty. Opening and irrigating the hematoma cavity proved adequate as treatment at cranioplasty.