USU and JHU-APL Collaboration Yields Innovative Devices for Rapid Treatment of Brain Hemorrhages
Researchers from Uniformed Services University and Johns Hopkins University have developed two portable devices to improve the treatment of brain hemorrhage in austere environments, potentially saving lives on the battlefield and beyond.
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| Two innovative handheld medical devices, developed through a USU/JHU-APL collaboration, could potentially save the lives of seriously injured deployed U.S. service members in remote, austere environments. (Photo by Staff Sgt. Jason Epperson, U.S. Army) |
April 3, 2025 by Vivian Mason
Traumatic head injuries can lead to brain damage or death without prompt treatment. To address the critical need for timely diagnosis and intervention, a team of researchers from the Uniformed Services University (USU) and the Johns Hopkins University Applied Physics Laboratory (JHU-APL) collaborated to create two prototype devices designed to significantly improve care and survivability among patients suffering from epidural or subdural hemorrhages in austere environments. These innovations include a portable cranial burr hole device for safely draining blood and a handheld scanner for detecting brain bleeding.
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Dr. David Brody, professor of NEU at USU and an expert in traumatic brain injury. (Photo credit: Tom Balfour, USU) |
The cranial burr hole device is compact and designed to treat patients suffering from epidural or subdural hemorrhages, which are life-threatening conditions requiring immediate intervention. This compact apparatus is intended to create burr holes to relieve pressure on the brain in under 15 minutes after localizing the hemorrhage. It is specifically designed for field use in austere environments, where there is no trained surgeon, hospital access, imaging devices, or operating room. This portability is crucial for saving lives in remote locations and on the battlefield.
The lightweight burr hole device uses fasteners to lock it onto the cranium and is designed to remain in place until the patient can be transported to a facility with neurosurgical care capabilities. Sterilizable components and a rechargeable power supply allow for reuse, making it a sustainable solution for resource-limited settings. Potential applications extend beyond the battlefield to wilderness medics, field workers, ships’ doctors, rural healthcare providers, and paramedics during mass casualties, demonstrating its versatility in various emergency scenarios.
The handheld scanner uses infrared light to rapidly differentiate between potentially life-threatening bleeding under the skull and non-threatening bleeding in the scalp or skin – something existing devices cannot reliably do. One of Brody’s key challenges in developing the scanner was ensuring it could accurately distinguish between bleeding in the scalp and brain. Because blood in the scalp is closer to the sensor, it produces a stronger signal, which can complicate detection.
“The way to tell the difference is that the light has to travel a longer distance through the scalp and skull to reach blood in the brain,” Brody explains. “So, we're using measurements of how far the light travels to make that distinction.”
This portable technology makes it a valuable tool for military settings, wilderness medicine, and regions lacking advanced imaging technologies, providing crucial diagnostic capabilities in resource-constrained areas.
Further research and development will allow the USU and JHU-APL team to refine the devices, test their ability to detect the depth and breadth of brain hemorrhage, and assess how well frontline medical providers can use them in high-pressure situations. This ongoing research is essential for optimizing the devices for real-world use.
Brody emphasizes the critical need for more research in prolonged field care for service members who experience severe head injuries and brain hemorrhages.
“Once a service member has bleeding inside the brain,” says Brody, “you really need to do something about it pretty fast. Otherwise, that individual isn’t going to do very well.”
He continues, “But, if a helicopter’s available quickly enough to help get that person to a CT scanner and pictures can be taken of the brain, and there’s a neurosurgeon available who can operate quickly to get the blood out, then that person may actually do pretty well.”
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Intracranial access device mounted on the skull. (Photo courtesy of HJF) |
Brody poses the challenging question, “But, what could we do if all that wasn’t available?” This critical question led him to consider what medics and corpsmen could do in the field with limited resources.
“What could be done to help keep the soldier, sailor, airman, or Marine alive for up to 72 hours until that service member could be safely evacuated?” Brody asked, driving the research team to find solutions for prolonged field care, with the goal of enabling advanced practice medics or corpsmen to easily carry them in a ruck or truck.
The team has been rigorously testing these prototypes on various models for about five years, ensuring their reliability and effectiveness.
“We need more advanced studies,” Brody observes. “Hopefully, we’ll get some companies interested in building miniaturized and ruggedized versions of them, prepare the devices for FDA approval, and then get them to the military.”
Brody drew inspiration for these innovative devices from the REBOA (resuscitative endovascular balloon occlusion of the aorta) catheter, a life-saving tool developed by former USU School of Medicine Associate Dean for Research Dr. Todd Rasmussen and Dr. Jonathan Eliason, both vascular surgeons. This catheter is used to save lives by addressing severe, non-compressible bleeding in the torso.
Brody finds that research offers an invaluable opportunity for creativity and innovation. “I like being able to think of new ideas and then see those ideas come to fruition,” he admits. “As long as there’s a chance, I'm going to keep coming back with more new ideas and keep trying new things.”
He says his research experience at USU has been exceptionally rewarding, noting the university's strong sense of shared mission and purpose in advancing military medicine.
“We’re here to improve outcomes for service members who are injured or who become sick doing the job that they're meant to do to protect our nation,” Brody remarks. “We're all on the same page and have the same mission. I really like that.”
Although he has never served in the military, Brody has a deep and abiding appreciation for military medicine, which he feels is his calling and a field where he can make a significant contribution.
“While at Landstuhl Regional Medical Center in Germany, I saw a lot of head injuries and became interested in military TBIs,” he recalls, describing his early exposure to the challenges of traumatic brain injury in a military setting.
He was later invited to Afghanistan as a consultant to help establish concussion clinics and MRI scanners, further solidifying his commitment to this area of research.
“That's when I think I really got the bug,” Brody remembers. “I was always interested in traumatic brain injury, but working closely with the military was the most interesting experience ever.”
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