Real-Time Non-invasive Assessment of Cerebral Hemodynamics With Diffuse Optical Spectroscopies in a Neuro Intensive Care Unit: An Observational Case Study

• Published in: Frontiers in medicine Vol. 7; p. 147
• Main Authors: Forti, Rodrigo M, Katsurayama, Marilise, Menko, Julien, Valler, Lenise, Quiroga, Andres, Falcão, Antonio L E, Li, Li M, Mesquita, Rickson C
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 28.04.2020
• Subjects: aneurysmal subarachnoid hemorrhage; cerebral blood flow (CBF); diffuse correlation spectroscopy (DCS); diffuse optical spectroscopy (DOS); Medicine; neuro intensive care unit; cerebral blood flow (CBF); diffuse optical spectroscopy (DOS); neuro intensive care unit; aneurysmal subarachnoid hemorrhage; diffuse correlation spectroscopy (DCS)
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2020.00147

Prevention of secondary damage is an important goal in the treatment of severe neurological conditions, such as major head trauma or stroke. However, there is currently a lack of non-invasive methods for monitoring cerebral physiology. Diffuse optical methods have been proposed as an inexpensive, non-invasive bedside monitor capable of providing neurophysiology information in neurocritical patients. However, the reliability of the technique to provide accurate longitudinal measurement during the clinical evolution of a patient remains largely unaddressed. Here, we report on the translation of a hybrid diffuse optical system combining frequency domain diffuse optical spectroscopy (FD-DOS) and diffuse correlation spectroscopy (DCS) for real-time monitoring of cerebral physiology in a neuro intensive care unit (neuro-ICU). More specifically, we present a case study of a patient admitted with a high-grade aneurysmal subarachnoid hemorrhage, who was monitored throughout hospitalization. We show that the neurophysiological parameters measured by diffuse optics at the bedside are consistent with the clinical evolution of the patient at all the different stages following its brain lesion. These data provide support for clinical translation of DOS/DCS as a useful biomarker of neurophysiology in the neuro-ICU, particularly in locations where other clinical resources are limited.