J Stroke.  2013 May;15(2):99-108. 10.5853/jos.2013.15.2.99.

Multimodality Monitoring in the Neurointensive Care Unit: A Special Perspective for Patients with Stroke

• Ko SB

• KMID: 1824945
• DOI: http://doi.org/10.5853/jos.2013.15.2.99

Abstract

Multimodality monitoring (MMM) is a recently developed method that aids in understanding real-time brain physiology. Early detection of physiological disturbances is possible with the help of MMM, which allows identification of underlying causes of deterioration and minimization of secondary brain injury (SBI). MMM is especially helpful in comatose patients with severe brain injury because neurological examinations are not sensitive enough to detect SBI. The variables frequently examined in MMM are hemodynamic parameters such as intracranial pressure, cerebral perfusion pressure, and mean arterial pressure; brainspecific oxygen tension; markers for brain metabolism including glucose, lactate, and pyruvate levels in brain tissue; and cerebral blood flow. Continuous electroencephalography can be performed, if needed. The majority of SBIs stem from brain tissue hypoxia, brain ischemia, and seizures, which lead to a disturbance in brain oxygen levels, cerebral blood flow, and electrical discharges, all of which are easily detected by MMM. In this review, we discuss the clinical importance of physiological variables as well as the practical applicability of MMM in patients with stroke.

Keyword

Critical care; Stroke; Physiologic monitoring; Coma

MeSH Terms

Brain
Brain Injuries
Coma
Critical Care
Electroencephalography
Glucose
Hemodynamics
Humans
Hypoxia, Brain
Intracranial Pressure
Ischemia
Lactic Acid
Monitoring, Physiologic
Neurologic Examination
Oxygen
Perfusion
Pyruvic Acid
Seizures
Stroke
Glucose
Lactic Acid
Oxygen
Pyruvic Acid