Dynamic Visualization of Hematoma Formation and Expansion in Craniocerebral Injury Using Biocompatible Near-Infrared Quantum Dots

Abstract Craniocerebral injury is a common life-threatening condition, in which the dynamic progression of hematoma plays a critical role in determining secondary injury and clinical outcomes. However, conventional imaging modalities such as computed tomography provide only static snapshots, lacking the capability for real-time monitoring of hematoma fluid dynamics. Here, a near-infrared-emitting Ag−In−Se@ZnS quantum dot (QD)-based optical imaging strategy is developed to enable real-time, dynamic visualization of the formation and expansion of hematoma following head trauma. Using a mouse impact model with the impact severity controlled by varying the drop height, two distinct hematoma spread patterns are identified. In the higher-impact model, QD signals quantitatively reveal rapid radial spread of hematoma from the impact site with sustained outward fluid flow over several hours. In contrast, the lower-impact model exhibits localized hematoma that expands slightly from the impact site initially but then stabilizes, remaining confined to a small region without further progression. Histopathological analysis confirms that the higher-impact model involves intracranial hematoma with associated neuronal injury, whereas in the lower-impact model, the absence of brain parenchymal damage, combined with the localized imaging pattern, indicates that the hematoma is confined to the superficial soft tissues. These results demonstrate that QD-revealed spatiotemporal patterns of hematoma flow correlate with the depth and pathological nature of injury, enabling non-invasive differentiation between subcutaneous and intracranial hematoma. By providing real-time insight into hematoma formation and active expansion, this approach addresses a critical gap in trauma management and holds promise for early differential diagnosis and timely therapeutic decision-making.