Multimodality neuromonitoring for perioperative brain protection

Abstract

Perioperative brain injury is unfortunately a common occurrence. A large body of evidence indicates that the two major causes of this injury are embolism and a mismatch between regional cerebral oxygen supply and demand. Multimodality neuromonitoring detects these developing signs of injury and assesses the effectiveness of corrective action. Three non-invasive modalities continuously measure (1) embolism and cerebral blood flow change using transcranial Doppler ultrasound, (2) regional cerebral oxygen balance with transcranial near-infrared spectroscopy, and (3) functional change in cerebral cortical synaptic activity via EEG. When guided by standardized intervention protocols, neuromonitoring reduces neurologic injury and hospital costs.