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Near-infrared spectroscopy (NIRS), applied to a human head, is a noninvasive method in neurointensive care to monitor cerebral hemodynamics and oxygenation. The method is particularly powerful when it is applied in combination with indocyanine green (ICG) as a tracer substance. In order to assess contributions to the measured optical density (OD) which are due to extracerebral circulation and disturb the clinically significant intracerebral signals, we simulated the light propagation in an anatomically representative model of the adult head derived from MRI measurements with the aid of Monte Carlo methods. Since the measured OD signal depends largely on the relative blood content in various transilluminated tissues, we weighted the calculated densities of the photon distribution under baseline conditions within the tissues with the changes and aberrations of the relative blood volumes which we expect to prevail under physiological conditions. Furthermore, the influence of the IGC dye as a tracer substance was assessed. We conclude that up to about different 70% of the measured OD signal may have its origin in the tissues of interest under optimal conditions, which is mainly due to the extrapolated high relative blood content of brain tissue along with the influence of ICG.

Monte Carlo simulation of light propagation in adult brain: influence of tissue blood content and indocyanine green