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Purpose <p>In older adults, brain injury due to trauma is associated with high mortality and poses diagnostic challenges due to atypical presentations and delayed access to computed tomography (CT) imaging. Subdural hematoma is the most frequent intracranial lesion in this population and often evolves insidiously, leading to diagnostic delays. Portable devices using near-infrared spectroscopy (NIRS) are emerging as bedside adjuncts for early detection of intracranial hemorrhage. The aim of this study was to assess diagnostic performance of CEREBO<sup>®</sup>, a portable device using NIRS, for detecting intracranial hemorrhage in the elderly patients (≥ 65 years) with suspected TBI, using CT as reference standard.</p> Methods <p>This prospective, double-blinded observational study was registered through Clinical Trial Registry of India (CTRI/063435) on 1st March 2024 and conducted in the emergency department of National Institute of Mental Health and Neurosciences, Bengaluru, India. Elderly patients (≥ 65 years) who had suspected TBI and were advised CT underwent CEREBO<sup>®</sup> scanning. Diagnostic performance was assessed by calculating sensitivity, specificity, accuracy, likelihood ratios and Youden’s index at subject and location levels.</p> Results <p>Final analysis included 159 of 181 enrolled patients. CT identified intracranial hemorrhage in 26.4% of scanned cranial measurement locations, with subdural hematoma being the most common lesion. At the subject level, CEREBO<sup>®</sup> demonstrated 96.7% sensitivity, 87.8% specificity, and 91.2% accuracy. Exploratory location-wise analysis showed 94.4% sensitivity, 92.1% specificity, and 92.7% accuracy.</p> Conclusion <p>CEREBO<sup>®</sup> demonstrated high diagnostic accuracy for detecting traumatic intracranial hemorrhage in elderly patients. As a rapid, portable bedside tool, it shows promise for supporting early triage in settings where timely CT access is limited. Further prospective studies are needed to evaluate its impact on clinical workflow and patient outcomes.</p>

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Early and safer triage in elderly traumatic brain injury using a portable NIRS - based device: clinical evaluation of CEREBO®

  • 期刊论文

  • 发表日期：

    2026年4月17日

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  • Neil Manjunath Salian,
  • Hemakshi Bansal,
  • Dhaval P. Shukla,
  • Subhas Konar,
  • Bhagavatula Indira Devi,
  • Aprajita Chaturvedi,
  • Akankshi Oberoi,
  • Jayksh Chhabra,
  • Allen Johnson

摘要

Purpose

In older adults, brain injury due to trauma is associated with high mortality and poses diagnostic challenges due to atypical presentations and delayed access to computed tomography (CT) imaging. Subdural hematoma is the most frequent intracranial lesion in this population and often evolves insidiously, leading to diagnostic delays. Portable devices using near-infrared spectroscopy (NIRS) are emerging as bedside adjuncts for early detection of intracranial hemorrhage. The aim of this study was to assess diagnostic performance of CEREBO®, a portable device using NIRS, for detecting intracranial hemorrhage in the elderly patients (≥ 65 years) with suspected TBI, using CT as reference standard.

Methods

This prospective, double-blinded observational study was registered through Clinical Trial Registry of India (CTRI/063435) on 1st March 2024 and conducted in the emergency department of National Institute of Mental Health and Neurosciences, Bengaluru, India. Elderly patients (≥ 65 years) who had suspected TBI and were advised CT underwent CEREBO® scanning. Diagnostic performance was assessed by calculating sensitivity, specificity, accuracy, likelihood ratios and Youden’s index at subject and location levels.

Results

Final analysis included 159 of 181 enrolled patients. CT identified intracranial hemorrhage in 26.4% of scanned cranial measurement locations, with subdural hematoma being the most common lesion. At the subject level, CEREBO® demonstrated 96.7% sensitivity, 87.8% specificity, and 91.2% accuracy. Exploratory location-wise analysis showed 94.4% sensitivity, 92.1% specificity, and 92.7% accuracy.

Conclusion

CEREBO® demonstrated high diagnostic accuracy for detecting traumatic intracranial hemorrhage in elderly patients. As a rapid, portable bedside tool, it shows promise for supporting early triage in settings where timely CT access is limited. Further prospective studies are needed to evaluate its impact on clinical workflow and patient outcomes.