Patient is scanned with AHEAD 300

Brain bleeding in head injuries quickly detected by handheld device in new trial

Image credit: BrainScope Company Inc

A commercially available handheld device can correctly identify internal damage in 97 per cent of head injury victims, a clinical trial has confirmed. This would allow hospital workers to rapidly decide whether a patient requires urgent medical attention.

The device – named AHEAD 300 – measures brain activity and uses an algorithm to calculate how much bleeding is likely to have occurred inside the skull.

While many injuries result in obvious damage, such as broken limbs, head injuries are often less conspicuous.

According to the Centres for Disease Control and Prevention, approximately 2.5 million Americans each year go to the emergency room with suspected head injuries, often following road accidents, falls or violent assaults. Most of these patients will receive a CT scan, but the vast majority have no structural brain injury.

CT scans – which use X-ray images from different angles to build up a picture of the inside of the body – expose patients to heavy doses of radiation.

A quick test for brain bleeding would reduce the need for these expensive scans.

“Before our study, there were no objective, quantitative measures of mild head injury other than imaging,” said Dr Daniel Hanley, director of the Brain Injury Outcomes Program at the Johns Hopkins University School of Medicine. “This work opens up the possibility of diagnosing head injury in a very early and precise way.”

The study involved 720 adult patients from 11 hospitals. All the patients had closed head injuries; their skulls had not been damaged.

Upon reaching the Emergency Department, the patients were seen by a doctor, who carried out standard assessments for head injuries. Afterwards, a technician took notes of their symptoms and then used the AHEAD 300 device.

The FDA-approved device, which was developed over eight years by BrainScope Company Inc, assesses the likelihood that a patient has more than 1ml of bleeding in the brain; a good indicator that the patient requires urgent medical attention.

The AHEAD 300 device does this by measuring electroencephalogram (EEG) data – tracking brain wave patterns from five points on the forehead. It compares 30 features of brain activity to healthy brain activity; for example, checking that the two sides of the brain are coordinated.

During the tests, which take five to ten minutes, the patients lie down wearing a disposable headset.

The patients were sorted into three groups; ‘yes’, ‘maybe’ and ‘no’, based on how much bleeding was estimated in the brain. The researchers then checked how accurate the device was in diagnosing head injuries, using information from CT scans, follow-up phone calls and medical records.

The sensitivity of detecting a serious brain injury was 97 per cent, or 152 out of 156 traumatic injuries being correctly identified.

“This technology is not meant to replace the CT scan in patients with mild head injury, but it provides the clinician with additional information to facilitate routine clinical decision-making,” Dr Hanley said.

“If someone with a mild head injury was evaluated on the sports or battlefield, then this test could assist in the decision of whether or not he or she needs rapid transport to the hospital. Alternatively, if there is an accident with many people injured, medical personnel could use the device to triage which patients would need to have CT scans and who should go first. Those showing a ‘positive’ for brain injury would go first.”

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