Do-it-Yourself Cerebral Hematoma Detection

February 28, 2013 EDT at 5:15 pm
Abby small

Abby, from Medlogic, demonstrates the Infrascanner 2000

The Infrascanner™ 2000, a hand-held, NIRS-based, device for detecting subdural hematomas, recently received FDA clearance.

The first showing of the product was at the ICU of the Future meeting in Los Angeles, February 21-22.  The technology inside this product goes back to the late Dr. Britton Chance, a brilliant biophysicist at the University of Pennsylvania.  I worked for Dr. Chance in 1972 while still an electrical engineering student at Penn building amplifiers for oxygen electrodes.  We re-connected a few decades later when we were both at an NIH workshop to assess neonatal neuromonitoring technology.  At that time Dr. Chance’s group had developed technology to use near infrared light to assess cerebral oxygen in a product called RunMan™.  Shortly after that, we got involved in some software development for the device that was being commercialized by a company called NIM run by Dr. Chance’s sons Sam and Peter.  We used RunMan as one of the measurements in our initial multimodal monitor prototype.

NIM never really got off the ground as a business and Dr. Chance’s technology was licensed by Infrascan, Inc a company in Philadelphia run by Baruch Ben Dor.  It seems Baruch’s team has finally gotten it across the finish line.  Baruch and I have known each other for several years as we both run small medical device companies.  We both had an unnecessarily prolonged time getting our products cleared by a dysfunctional FDA process (more on this in another post).

Clarence

Clarence Carlos

A lengthy FDA experience translates into a period where you need to keep your company alive to benefit from your work but can’t sell your product for the income to do it. Knowing what we went through, I’m happy to see their product finally on the market.

A company called Medlogic, based out of Pittsburgh, is now selling the product. Medlogic is run by Clarence Carlos, a fascinating and amazingly connected person who I spent some time with in a bar in LA.  As a former football player he is developing the untapped sports injury market to quickly assess the brain following a blow to the head. He is working with school systems on a national level and already has the device in the hands of the Pittsburgh Steelers.  They are also exploring the obvious applications in pre-hospital and hospital care.

 

No hematomas in this brain

No hematomas in this brain

The current Infrascanner 2000 is easy to operate.  It provides a diagram of the head much like that seen on an EEG headbox with eight positions marked for you to test, four left and four right.  The device steps you through collecting a measurement at each site by holding the unit to the head and pressing a button…very easy. This pattern supposedly will provide a quick assessment of the presence of subdural hematomas across the cortex.  I tried the unit myself.  My do-it-yourself scan was quick and easy and found no hematomas!

The German Brain: ANIM 2013

January 30, 2013 EDT at 4:55 pm

ANIMThe Neurocritical Care Society arranged a joint meeting with ANIM in Mannheim, January 23-27, 2013.  ANIM is the Arbeitstagung  NeuroIntensiv- und Notfallmedizin which is the Workgroup on Neurointensive and Emergency Medicine.

Group

A few of the attendees at ANIM

There were two days with NCS sponsored sessions including two on neuroscience nursing.  ANIM was interesting and a lot of fun. It did not let me down in terms of seeing and leaning new stuff and it provided ample social opportunities to share a beer with old and new friends…my definition of an excellent meeting.

Nursing

The nursing sessions brought together nurses from the US and Germany to discuss and compare nursing issues.  Each speaker in the morning session was balanced by one from the other country.  From the U.S. were Mary Kay Bader, Cindy Bautista, Susan Yeager, Karen March, DaWai Olson, Sarah Livesay, and Sheila Alexander.   Cindy gave a nice overview of neuromonitoring from Yale’s perspective.  I learned that Yale-New Haven is now the fourth largest medical complex in the US.  And DaiWai, to his credit, even made the German attendees laugh.  I attended most of these sessions as I firmly believe the future of neuromonitoring in critical care is going to be influenced significantly by neuroscience nurses.  I also attended their morning session because it had a great breakfast spread…and I was doing some “late night reporting” for this blog the night before and had to go from bed to lecture very quickly the morning of the symposium.

Meeting

Hacke

Dr. Werner Hacke listening to The Codes and Dynamite

Gene Sung (President of NCS) and Werner Hacke (Heidelberg) opened the joint meeting.  There were several topics related to neuromonitorng.  Peter LeRoux gave a nice overview of multimodal neuromonitoring. Jed Hartings talked about monitoring cortical spreading depressions and his COSBID research group.  Jan Claassens talked about the importance of monitoring EEG.

One of the highlights was Stephan Mayer’s talk on the Future of Neurocritical Care…”Where’s My Tricoder”.  He reviewed the specs for the Star Trek Tricoder, the gizmo that Dr. McCoy used to heal all illnesses in the TV series.  He reminded us that we already have amazing technology today such as the Hemedex CBF monitor, the Neuroptics pupillometer, microdialysis, Licox, and many other “futuristic” technologies.  Of course the part of his talk I liked best was when he asked who really invented the Tricoder.  His next slide was of me, our multimodal monitor, and scenes of the Burning Man art festival…and he claimed I invented it during one of my trips (no pun) to that alternative festival in the desert.  Well, of course I didn’t invent the Tricoder, but I did make a solar powered smoothie machine for Burning Man and made smoothies for those walking around in the desert looking at art.  I plan to make it controllable by EEG and have applied to DARPA for funding (the subject of a future post).

There were several neuromonitoring related posters.  Stephen Spainhour and DaWai Olson presented a poster showing how misleading manually recorded ICP values (as seen in the medical record) can be for research projects due to their irregularity and the fact that they may not reflect reality.  My guess is that this applies beyond research and for more than ICP.  Their work is enlightening and supports the rationale for connected devices and continuous data collection.

A neurocritical care meeting would not be complete without a performance by the Codes.  They were followed by Dynamite, rumored to be Dr. Hacke’s favorite band.  They were the awesome.

Social Activities

Underberg and Oliver

Dr.s Sakowitz and Unterberger

Neurosurgeon sandwich

I’ve always learned more outside of the lecture hall and this was true at ANIM.  Heidelberg was nearby and served as a focal point for entertainment. As many know, the castle in Heidelberg has the world’s largest wine barrel…….so we were off to a good start.  There was a tour of Heidelberg one evening for the nursing contingent.  One evening I ended up at a dinner with the speakers and organizers…obviously because of my press credentials for this blog.  It was in a typical quaint Heidelbergerish restaurant with long benches and tall glasses. It was hosted by Andreas Unterberg (head of neurosurgery at Heidelberg). I got to know Oliver Sakowitz, another neurosurgeon at Heidelberg. I experienced a rare “neurosurgeon sandwich” at the meeting (see picture) as I sat between two of them. On the right is Carla Jung (Heidelberg) and on the left is Dortja Engel (St. Galen). My smile shows you how much I like sandwiches. I would marry both of them if I were 30 years younger…and believed in marriage…so I had to settle for sharing some beers.  But I did enjoy some snowboarding with Doortja the following week in Davos.

Drs. Varelas and Hanley

Drs. Varelas and Hanley standing under Pan

Dr. Hartings and Unidentified Friend

Lori Jed Oliver

Dr. Sakowitz, Dr. Stone (retired), Dr. Shutter, Dr. Hartings

In the afternoon of the last day we were bussed to Schwetzingen Palace and Gardens which date back to the 1300s.  We started the afternoon in a brewery next to the palace. The alcohol served as a neuroprotectant had anyone slipped on the ice during the ensuing 2-hour garden tour.  Despite the winter weather and some of the statues being boxed up, the gardens still proved magnificent and the stories about Carl Theodore, one of the residents in the 1700s were fascinating. We then toured the palace where you got a real sense of life in these times.  Then, of course, more beer in the neighboring brewery and the bus trip home.

I found another focal point of “learning” was the lobby bar at the Maritim Hotel where many attendees were staying.  Lisa the bartender gets credit for keeping track of the circles of chairs that would form and re-form as conversations and groups shifted through the evening.

Next year ANIM is in Hannover January 22-25, 2014.  I don’t think they will have the joint session with NCS…but I believe they are trying to organize another joint meeting in the future.  If they do…I recommend it!