Advanced neurological monitoring

Neurological monitoring, during and after surgery, potentially allows the early detection of insults to the brain, and enables the optimization of cerebral haemodynamics and oxygenation in order to prevent neurological injury. Global and regional brain monitoring is not only elucidating the complex pathophysiology of the injured brain and emphasizing its heterogeneous nature, but is also enabling timely, target-guided therapeutic interventions and prognostication. Developments in non-invasive monitoring techniques, coupled with invasive modalities such as intracranial pressure measurement, jugular bulb and brain tissue oximetry, and cerebral microdialysis provide a multimodal approach for continuous, integrated cerebral monitoring. There is mounting evidence that individualized, patient-specific therapy, as guided by several monitoring techniques, may bring us closer to the goal of improving outcome after brain injury.