Multimodal Brain Monitoring and Cerebral Vascular Reactivity

The organization of a modern Neurocritical Care Unit with complex monitoring and computerized data collection provides a unique environment of neural bioinformatics and an opportunity to study pathophysiological mechanisms of acute brain lesion and the effect of treatment, as in a clinical laboratory. Multimodal Brain Monitoring with advanced techniques assessing cerebrovascular reactivity, brain oxygenation and chemistry and cerebral blood flow allow a real-time definition of physiologic end points that may be used to customize goal-directed therapy and contribute to improving outcome from severe traumatic brain injury (TBI). This complexity requires a multidisciplinary approach, therefore the book has three dimensions: population, methodological and clinical. The methodological section includes a systematic review of brain monitoring, neurocritical care bioinformatics and cerebrovascular reactivity evaluation at the bedside. The clinical section included a prospective study where the relevance of multimodal brain monitoring, targeting "optimal CPP" and early recognition of brain and systemic phenomenon responsible for secondary injury was investigated.