Monitoring of head injured patients
Abstract
This article reviews recent advances in multimodality monitoring of patients following severe head injury during the period of 2004-2005. Whilst intracranial pressure measurement remains the cornerstone of neuromonitoring, analysis of the intracranial pressure waveform provides additional information, which may help guide treatment and predict outcome. Non-invasive detection of intracranial hypertension and assessment of cerebral perfusion pressure and autoregulation is the focus of ongoing research. Although jugular venous saturation monitoring remains a useful method for detecting global hypoperfusion its sensitivity to regional ischaemia is low. Brain tissue oxygen monitoring overcomes this deficiency and sheds new light on the pathophysiology of cerebral ischaemia following brain injury. Further studies are required to define ischaemic thresholds and their association with outcome. Extracellular brain pH has been recently linked to outcome and further studies are required to establish the role of pH regulation. Monitoring of brain metabolism using a cerebral microdialysis continues to develop its niche in clinical neuromonitoring, although it currently remains a research tool. Multimodality neuromonitoring plays an importan...Continue Reading
References
Raised parenchymal interleukin-6 levels correlate with improved outcome after traumatic brain injury
Direct comparison of cerebrovascular effects of norepinephrine and dopamine in head-injured patients
Citations
Delayed-onset deficits in verbal encoding strategies among patients with mild traumatic brain injury
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