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Intracranial Pressure and Multimodal Monitoring

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Neurocritical Care Informatics

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Abstract

Secondary brain injury results from ischemia, tissue hypoxia, and a cascade of ongoing metabolic events. Neuromonitoring has evolved over the last two decades with the goal of preventing, detecting, and attenuating the damage from these secondary events. Typical monitored parameters include intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Advanced multimodal monitoring includes monitoring of cerebral blood flow (CBF), brain tissue oxygenation (transcranial oximetry, jugular bulb oximetry, brain tissue oxygen tension), and brain metabolism (intracerebral microdialysis). In this chapter, we will review basic principles of brain physiology and the complex and dynamic interactions between these parameters. In the future, neuromonitoring will be supported by advanced signal processing and analysis that will enable clinicians to synthesize information and form hypotheses that best explain the current situation. Such an integrated system will translate data into actionable information and provide situational awareness.

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Authors and Affiliations

  1. Neurosurgical ICU, University of Miami Hospital, Miami, FL, USA

    Amedeo Merenda

  2. Clinical Neurology, Neurosurgery and Neurocritical Care, University of Miami Miller School of Medicine, Miami, FL, USA

    Amedeo Merenda

  3. Center for Neurocritical Care, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA

    Michael De Georgia

  4. Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Michael De Georgia

  5. Clinical Neurology and Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA

    J. Claude Hemphill III

  6. Neurocritical Care, University of California, San Francisco, San Francisco, CA, USA

    J. Claude Hemphill III

  7. Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA, USA

    J. Claude Hemphill III

  8. Neurocritical Care, San Francisco General Hospital, San Francisco, CA, USA

    J. Claude Hemphill III

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  1. Amedeo Merenda
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  2. Michael De Georgia
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  3. J. Claude Hemphill III
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Correspondence to Amedeo Merenda .

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  1. University Hospitals Cleveland Medical Center, Cleveland, OH, USA

    Michael De Georgia

  2. Case Western Reserve University, Cleveland, OH, USA

    Kenneth Loparo

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Merenda, A., De Georgia, M., Hemphill, J.C. (2020). Intracranial Pressure and Multimodal Monitoring. In: De Georgia, M., Loparo, K. (eds) Neurocritical Care Informatics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59307-3_4

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