Brain injuries are being diagnosed with a blood test rather than a costly CT scan

It happens every day at North Shore University Hospital’s busy emergency department in Manhasset — patients who have fallen and hit their head are brought in for evaluation and possible treatment.

That process can take time and involve exposure to radiation, through a computed tomography (CT) scan that may not even be necessary.

For the past four months, the hospital has been using a new tool that can help determine whether a patient has suffered a brain injury with the use of blood instead of radiation.

North Shore is the first facility in the state, officials said, to implement the i-STAT Alinity TBI test by Abbott, which measures the presence of two proteins — biomarkers — in blood that signal brain injury.

"These are proteins that are found in the brain so they shouldn't be in your blood," said Dr. Tylis Chang, vice-chair of pathology at Northwell Health. "By measuring them and seeing you have it in your blood, that tells us there's a problem.

If both the proteins are below a certain threshold, doctors can be confident the patient doesn’t have a significant enough traumatic brain injury to warrant a CT, said Dr. Chidubem Iloabachie, associate chair of emergency medicine at North Shore.

The results are available within 15 minutes on a handheld device. Northwell has chosen to run the test through its own lab, which returns results in about 30 minutes. 

The current test, which uses whole blood, was approved by the Food and Drug Administration in 2024 for people 18 years of age and older. Whole blood contains red and white blood cells as well as platelets suspended by plasma.

Research into a blood-based test for brain injuries started over a decade ago with funding from the U.S. Department of Defense, which was looking for a way to diagnose traumatic brain injuries in the field.

The technology also can be useful for youth athletics, and officials at Abbott said they were currently having clinical trials for the test focused on children under 18. Last year, the motorcycle racing organization, MotoAmerica, became the first professional sports organization to use the test on-site.

At North Shore, many of their patients with possible traumatic brain injury are senior citizens who have fallen.

"One of the most common causes for people to come to the emergency department is a mild traumatic brain injury," Iloabachie said. "We would define it as a blunt force trauma event where something hits your head or your head hits something."

Clinicians use the Glasgow Coma Scale, which measures speech, eye opening and motor response as a first level of evaluation. If that response is high enough, then the head injury is determined to be mild and the blood test can be used.

"Even when those algorithms are followed, we still perform head CTs on an exorbitant number of these patients with mild traumatic brain injuries," Iloabachie said. "The overwhelming majority of these CT scans are negative so it begs the question if they are even necessary to do in the first place."

He pointed out each CT scan exposes patients to ionizing radiation, costs money to be performed and read by a radiologist and adds time to an emergency department stay.

There are a few caveats for the blood test. Patients must be tested within the first 24 hours of their injury, cannot be on blood thinners, have seizures or have penetrating trauma, such as a gunshot wound or a stab wound.

So far, North Shore has run 135 tests on patients and avoided CT scans on about one-third of them, officials said.

"The test cannot replace a CT scan, that's a really high bar," Chang said. "But what it can do is in the right patient population, we can say, 'You don't need a CT scan.' "

According to the Department of Defense, members of the U.S. military suffered over 436,000 traumatic brain injuries classified as mild between 2000 and 2025.

The agency funded research that led to the first test to detect the proteins by California based-Banyan Biomarkers in 2018. Abbott was brought in to make the technology more accessible. Earlier versions of the test had a 12-hour testing window instead of 24 and tested plasma that had to be separated from the whole blood.

"The original prototypes took four hours," said Dr. Beth McQuiston, a neuroscientist and medical director for Abbott's diagnostics business. "You have to optimize it so that it fits into the normal course of health care. And then you want to make it repeatable, so that it works the same in one hospital versus another hospital ... we are making the invisible visible"

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.