The injured brain generally needs intensive treatment on the ICU. Due to anesthesia, monitoring of neurological signs is impossible; therefore, multi-parameter brain monitoring plays an important role. A recent exciting proposal is the monitoring of the so-called 'optimal CPP', the strategy which theoretically minimizes the risk of autoregulation failure.

Subarachnoid Haemorrhage

Classically, brain monitoring after SAH can be divided into the time spent on the ICU, with the patient supported by ventilation, and afterwards. Brain monitoring in the ICU does not differ generally from monitoring after TBI. After the ICU period, monitoring is mainly focused on the detection of vasospasm and dysutoregulation of blood flow, mainly using transcranial Doppler ultrasongraphy (TCD) or near-infrared spectroscopy (NIRS).

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Traumatic Brain Injury

Multimodal brain monitoring after TBI includes various modalities such as ICP, CPP, brain tissue oxygenation, cerebral blood flow, microdialysis, etc. Various secondary indices like PRx, autoregulation indices, and compensatory reserve index (RAP) may aid in the management of TBI patients to avoid secondary brain insults.

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