Near-infrared laser spectroscopy as a screening tool for detecting hematoma in patients with head trauma

Introduction: Among imaging techniques, computed tomography (CT) is a reliable method for detecting intracranial hematomas in patients with head trauma, but it is not generally available in special circumstances like prehospital situations and harsh conditions such as those following an earthquake.Objective: The objective of this study is to determine if near-infrared spectroscopy (NIRS) is useful for performing CT scans on patients with closed head trauma that present to medical centers that do not have the ability to perform a CT scan or in prehospital or harsh situations. Near-infrared spectroscopy and CT scan were compared according to sensitivity and specificity.Methods: This was an observational, prospective study. One hundred forty-eight patients admitted to Rasool Akram General Hospital in Tehran, Iran with head injuries during a one-month period were studied using NIRS and CT. The observational, prospective study was conducted and sensitivity, specificity, positive and negative predictive values of NIRS were calculated. Chi-square and Kappa analysis was performed, and a p-value <0.05 was considered significant.Results: According to the CT scan findings, 54 (36.5) of the patients developed intracranial hematoma. The NIRS examination showed that 69 patients (46.6) might have intracranial hematoma. The number of true negatives was 73 and the number of false negatives was six patients. The sensitivity and specificity of NIRS examination was 88.9 and 77.7, respectively.Conclusions: This study speculates that NIRS may be a useful screening tool to detect intracranial hematoma. This capability could be useful in special situations like in a deprived area, medical centers without CT scan capabilities, prehospital situations, and in harsh conditions like those after an earthquake or other disasters that causes increased numbers of victims with closed head trauma. © World Association for Disaster and Emergency Medicine 2008

Subarachnoid hemorrhage following uneventful thyroid orbital decompression

A 24-year-old woman developed subarachnoid hemorrhage and left frontal lobe ischemia following uneventful right transconjunctival orbital decompression for thyroid-related immune orbitopathy. CT, MRI, CT angiography, and carotid angiography confirmed subarachnoid hemorrhage and brain ischemia on the left side without any cerebral vascular abnormalities on either side. All tests were unremarkable. She fully recovered at last follow-up, 4 months after surgery. We did not find any reason for the subarachnoid hemorrhage and left frontal lobe ischemia. This complication should be considered after orbital surgery for patients with thyroid-related immune orbitopathy. ©2007The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc

Investigation of dosimetry in four human head models for planar monopole antenna with a coupling feed for LTE/WWAN/WLAN internal mobile phone

The objective of the present study is to evaluate the Specific Absorption Rate (SAR) within the human head model exposed to the radiation of planar monopole antenna with T-shaped coupling feed and an inductive shorting strip. The presented design has a compact structure, a planar configuration and occupying a small size of 36×20mm2. Two wide bands can be generated by the proposed antenna 546 MHz (734-1280 MHz) and 1066 MHz (1934-3000 MHz) for the LTE/WWAN/WLAN internal mobile phone. The antenna performance parameters comprising return loss, radiation patterns, and gain are discussed. In this research work four different human head models have been implemented: homogenous spherical head, spherical seven layer model, Specific Anthropomorphic Mannequin (SAM) phantom and HUGO human head model. On the other hand the effects of operating frequency and gap distance between the mobile phone antenna and the human head model on distributions of the SAR inside the human head are investigated. All the simulations are done for three different distances between the antenna and the head model (5 mm, 10 mm and 20 mm). Moreover, the SAR levels for the head tissues are calculated in accordance to the two currently accepted standards: Federal Communications Commission (FCC) and International Commission on Non-Ionizing Radiation Protection (ICNIRP)

Prospective multicenter assessment of patient preferences for properties of gadolinium-based contrast media and their potential socioeconomic impact in a screening breast MRI setting

Objective: It is unknown how patients prioritize gadolinium-based contrast media (GBCM) benefits (detection sensitivity) and risks (reactions, gadolinium retention, cost). The purpose of this study is to measure preferences for properties of GBCM in women at intermediate or high risk of breast cancer undergoing annual screening MRI. Methods: An institutional reviewed board-approved prospective discrete choice conjoint survey was administered to patients at intermediate or high risk for breast cancer undergoing screening MRI at 4 institutions (July 2018-March 2020). Participants were given 15 tasks and asked to choose which of two hypothetical GBCM they would prefer. GBCMs varied by the following attributes: sensitivity for cancer detection (80-95%), intracranial gadolinium retention (1-100 molecules per 100 million administered), severe allergic-like reaction rate (1-19 per 100,000 administrations), mild allergic-like reaction rate (10-1000 per 100,000 administrations), out-of-pocket cost ($25-$100). Attribute levels were based on published values of existing GBCMs. Hierarchical Bayesian analysis was used to derive attribute "importance." Preference shares were determined by simulation. Results: Response (87% [247/284]) and completion (96% [236/247]) rates were excellent. Sensitivity (importance = 44.3%, 95% confidence interval = 42.0-46.7%) was valued more than GBCM-related risks (mild allergic-like reaction risk (19.5%, 17.9-21.1%), severe allergic-like reaction risk (17.0%, 15.8-18.1%), intracranial gadolinium retention (11.6%, 10.5-12.7%), out-of-pocket expense (7.5%, 6.8-8.3%)). Lower income participants placed more importance on cost and less on sensitivity (p < 0.01). A simulator is provided that models GBCM preference shares by GBCM attributes and competition. Conclusions: Patients at intermediate or high risk for breast cancer undergoing MRI screening prioritize cancer detection over GBCM-related risks, and prioritize reaction risks over gadolinium retention. Key points: • Among women undergoing annual breast MRI screening, cancer detection sensitivity (attribute "importance," 44.3%) was valued more than GBCM-related risks (mild allergic reaction risk 19.5%, severe allergic reaction risk 17.0%, intracranial gadolinium retention 11.6%, out-of-pocket expense 7.5%). • Prospective four-center patient preference data have been incorporated into a GBCM choice simulator that allows users to input GBCM properties and calculate patient preference shares for competitor GBCMs. • Lower-income women placed more importance on out-of-pocket cost and less importance on cancer detection (p < 0.01) when prioritizing GBCM properties

MRI of degenerative cysts of the lumbar spine

Degenerative cysts of the lumbar spine encompass a heterogeneous group of cystic lesions that are presumed to share a common aetiology. Some of these cysts may be incidental findings, whereas others may produce acute or chronic symptoms. These cysts have been categorized using various combinations of topographic and pathological characteristics and by their attachment to or communication with a specific spinal structure. © 2007 The Royal College of Radiologists

Left somatosensory cortex tumor presented with radicular hand pain and paresthesia

Concurrent lesions in the brain and spinal cord, which can produce similar symptoms are truly confusing situations. Herein, we report on a 56-year-old woman who suffered from an intermittent radicular pain and paresthesia in her right upper limb and mild headache. Imaging showed a cervical vertebral disc herniation and a small round tumor of the somatosensory cortex with clear border, considered as a little meningioma which could be followed. To deal with these two concurrent lesions, we faced a challenging condition