Near-infrared spectroscopy for intracranial hemorrhage detection in traumatic brain injury patients: A systematic review

Purpose: To synthesize evidence of the use of near-infrared spectroscopy (NIRS) to detect intracranial hemorrhage in traumatic brain injury (TBI) patients. Methods: The literature search was conducted in PubMed and Google Scholar (from inception to July 2021). Results: 216 original articles were found, 197 of which were omitted, and the final review contained 19 original articles covering 2291 patients. Conclusion: For patients with TBI, a NIRS test may be useful as a screening tool for intracranial hemorrhage, especially at the prehospital level. Negative results may help rule out intracranial hemorrhage and may remove the need for more head computed tomography (CT) scanning. Prehospital testing may guide the decision of whether the patient should be transferred to a craniotomy-equipped specialized hospital. NIRS can also be useful in situations when CT is not available. For future research, a significant objective is to show whether the effects of NIRS can improve outcomes and lead to meaningful improvements in clinical practice and decision making.