TBI is an acquired brain injury that occurs due to a sudden trauma causing damage to the brain. When the head suddenly and violently hits an object, or when an object pierces the skull and enters the tissues of the brain, it can lead to TBI.
TBI can be mild, moderate, or severe, depending on the extent of brain damage. Mild TBI could result in loss of consciousness for a few seconds or minutes, headache, confusion, dizziness, blurred vision, lightheadedness, ringing in the ears, fatigue, bad taste in mouth, change in sleep patterns, behavioral or mood changes, loss or trouble with memory, difficult to concentrate or pay attention. Moderate and severe TBI may lead to similar symptoms along with severe headache that worsens and continues for a longer duration with repeated nausea or vomiting, convulsions or seizures, dilation of one or both the pupils of eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, increased confusion, restlessness, or agitation.
TBI is considered to be a major source of health loss and disability worldwide. In the United States, around 52000 deaths per year result from TBI. More than 100,000 lives are lost every year in India, with over 1 million suffering from serious head injuries. The data shows that one person in India dies every 6 to 10 minutes due to a traumatic brain injury. Globally, around 50 million people are injured every year and about 1.2 million are estimated deaths.
The most common way to assess TBI is the Glasgow Coma Scale (GCS). It is a neurological scoring system used to evaluate conscious levels after head injury. It comprises the sum score of the values from three components: eye, motor, and verbal response. TBI is classified as mild (GCS 15–13), moderate (GCS 12–9), and severe (GCS < 8). However, factors such as hypoxia (deficiency in the amount of oxygen reaching the tissues), hypotension, and alcohol intoxication can all affect GCS, thus affecting the diagnosis.
Providers usually find GCS challenging to use. Thus, inconsistent results are obtained. GCS is also affected by factors such as intoxication, drugs and polytrauma injuries. Often, the eye and the vocal response are influenced by sedative agents or tracheal intubation, leading some to suggest the use of the motor score alone. Additionally, GCS is symptom-based, and has a poor correlation with specific intracranial pathology.
CEREBOⓇ is a non-invasive brain haemorrhage detection device that detects intracranial bleed among TBI patients without using any harmful radiation. It does not require any expert interpretation and hence can be used easily by trained personnel. This allows the device to be used not just in hospitals or clinics but remote rural centres and hard to reach military bases. The device is based on optical technology where we are using Near Infrared light that penetrates skull to detect the bleed. It is very easy to use following three simple steps - (i) switch on the device, (ii) select location and press trigger (iii) and long press OK to generate a result. The optical measurement is then analysed by a unique algorithm that determines the presence or absence of intracranial bleed along with its probable location.
CEREBOⓇ detects intracranial bleed non-invasively and without using any harmful radiation. It helps to frequently assess the patients and detect the hematomas at an early stage thereby reducing the risk of complications. Frequent assessment is essential for asymptomatic patients or patients with delayed hematoma. CEREBOⓇ is a battery-operated device that weighs approximately 1Kg making it a portable device and can be used at the injury site. Also, compared to other traditional imaging devices like a CT scan, CEREBOⓇ takes very less time to assess and generate the result within 2 minutes.
CEREBOⓇ can be used for any brain trauma patient irrespective of gender, age and ethnicity. The cause of trauma could be anything from a road traffic accident to fall, which has led to brain impact. Since it does not use any harmful radiation, anybody from a new-born to an adult to old age person can be assessed with this. Also, other vulnerable patients like pregnant ladies, lactating mothers, unconscious patient or patients with magnetic implants can also be assessed with CEREBOⓇ.
Additionally, CEREBOⓇ can be very useful in sports injury and military basecamps to evacuate the injured persons immediately.
Intracranial bleeding is a life-threatening emergency condition referring to acute bleeding inside one’s skull or brain.
CEREBOⓇ’s patented technology uses a combination of variables like source detector separation, spot size, laser power and patented optical coupling methods, that ensures that the near infrared light reaches the deep brain tissues to determine the presence of intracranial bleed.
Yes, but currently, it is being offered for trauma patients only who had a brain impact. We are now validating if CEREBOⓇ can accurately measure the haemorrhagic strokes arising from uncontrolled blood pressure in basal ganglia, pons and cerebellum.
CEREBOⓇ is designed to measure haemorrhages greater than 2mL at a depth of 3-3.5 cm from scalp. It can therefore measure small to large hemorrhages that are often asymptomatic or mildly symptomatic. These include subdural haemorrhages, epidural haemorrhages and intracerebral haemorrhages or contusions. CEREBOⓇ is not designed to measure very deep haemorrhages like the one originating in the brain stem, which are often accompanied by apparent clinical symptoms.
Yes, It can provided that the probes are placed 0.5cm away from the spot of the bleed.
No. The probes are designed in a way that they sit between the hair follicles and therefore the head need not be shaved for taking the measurements. However, hair parting must be done neatly in a way that the scalp is exposed for probe placement.
It is preferred that the head is oil and dirt free. Hence it is recommended to dust off the patient’s head before the measurements are taken with CEREBOⓇ.
TBI can be mild, moderate, or severe, depending on the extent of brain damage. No need to worry. The amount of heat generated on the skin is so minimal that you cannot feel it or measure it with a conventional thermometer. The heat we mention our device registers amounts to less that 1/1000 of a degree Celsius (oC).
Absolutely. The light source is safe, and the measurement procedure is neither painful nor uncomfortable.
CEREBOⓇ detects the intracranial bleed. In head trauma, an intracranial bleed may exert the pressure which causes the midline shift and this would be detected. But the device will only say there is an abnormality, and will not specify whether the abnormality is due to intracranial bleed or midline shift caused by the bleed. Sometimes, a midline shift may be caused by other anomalies like tumour, abscess but currently the device is designed only for detecting intracranial bleed and hence it can detect the midline shift if caused by intracranial bleed.
The system will work at any moderate ambient temperature, i.e., from 10oC to 30oC. Deviations may occur for higher and lower temperatures but the impact is minimized through temperature control mechanisms which make it operational from 0oC to 50oC.
True. The brain is a complex system consisting of five different layers. To reach the brain, light needs to traverse through all of them including the scalp, skull and cerebrospinal fluid. However, we operate in an optical window that is comparatively transparent to our wavelength. With the help of our patented probe and technique, it ensures that we accurately measure the level of hemoglobin. NIRS identifies intracranial bleeding by detecting the asymmetry in light absorption over the left and right side of the brain.
There are no adverse effects seen with CEREBOⓇ. A slight indentation can be seen due to the probe placement which disappears on its own after few minutes.
No. CEREBOⓇ is not intended to replace a CT scan. It can help to prioritize the patient and decide whether the patient needs to go for further imaging or not. It can be used in the preliminary examination or as an adjunct to CT scans within 72 hours from injury.