Multimodal Neuromonitoring of Patients with Severe Brain Damage

  • Toshiyuki Shiogai
  • Kazuo Takeuchi


Neurophysiological brain monitoring (neuromonitoring), is being increasingly applied in the intensive care setting [1]. Neuromonitoring includes conventional EEG, compressed spectral arrays (CSA), measurement of brainstem auditory evoked potentials (BAEP) and short-latency somatosensory evoked potentials (SSEP), also measurement of intracranial pressure (ICP), cerebral perfusion pressure (CPP) [2], and cerebral blood flow, as well as transcranial Doppler sonography (TCD).


Brain Death Cerebral Perfusion Pressure Brainstem Auditory Evoke Potential Median Nerve Stimulation Severe Brain Damage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Hacke W (1985) Neuromonitoring. J Neurol 232: 125–133PubMedCrossRefGoogle Scholar
  2. 2.
    Shiogai T, Sakuma T, Nakamura M, Maemura E, Kadowaki C, Hara M, Ogashiwa M, Takeuchi K (1989) Neuronal dysfunction and intracranial pressure: Multimodal monitoring of severely brain-damaged patients. In: Hoff JT, Betz AL (eds) Intracranial pressure VII. Springer Berlin Heidelberg, New York, pp 665–667CrossRefGoogle Scholar
  3. 3.
    Hockaday JM, Potts F, Epstein E, Bonazzi A, Schwab RS (1965) Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest. Electroencephalogr Clin Neurophysiol 18: 575–586PubMedCrossRefGoogle Scholar
  4. 4.
    Takeuchi K, Takeshita H, Takakura K, Shimazono Y, Handa H, Gotoh F, Manaka S, Shiogai T (1987) Evolution of criteria for determination of brain death in Japan. Acta Neurochir (Wien) 87: 93–98CrossRefGoogle Scholar
  5. 5.
    Walker AE (1985) Cerebral Death, 3rd edn. Urban and Schwarzenberg, Baltimore-Munich, pp 157–195Google Scholar
  6. 6.
    Ingvar DH (1974) Report of the committee on cessation of cerebral function. Electroencephalogr Clin Neurophysiol 37: 530–531Google Scholar
  7. 7.
    Stone JL, Ghaly RF, Hughes JR (1988) Evoked potentials in head injury and states of increased intracranial pressure. J Clin Neurophysiol 5: 135–160PubMedCrossRefGoogle Scholar
  8. 8.
    Shiogai T (1989) Evaluation of the diagnosis of brain death: Part I. Brainstem auditory evoked potentials (in Japanese). Brain Nerve 41: 73–83PubMedGoogle Scholar
  9. 9.
    Moller AR, Jannetta PJ, Bennett M, Moller MB (1981) Intracranially recorded responses from the human auditory nerve: New insights into the origin of brainstem evoked potentials ( BSEPs ). Electroencephalogr Clin Neurophysiol 52: 18–27PubMedGoogle Scholar
  10. 10.
    Sohmer H, Gafni M, Havatselet G (1984) Persistence of auditory nerve response and absence of brain stem response in severe cerebral ischemia. Electroencephalogr Clin Neurophysiol 58: 65–72PubMedCrossRefGoogle Scholar
  11. 11.
    Allison T, Hume AL (1981) A comparative analysis of short-latency somatosensory evoked potentials in man, monkey, cat and rat. Exp Neurol 72: 592–611PubMedCrossRefGoogle Scholar
  12. 12.
    Momma F, Sabin HI, Symon L, Branston NM (1987) Clinical evidence supporting a subthalamic origin of the P15 wave of the somatosensory evoked potentials to median nerve stimulation. Electroencephalogr Clin Neurophysiol 67: 134–139.PubMedCrossRefGoogle Scholar
  13. 13.
    Desmedt JE (1985) Critical neuromonitoring at spinal and brainstem levels by somatosensory evoked potentials. Cent Nery Syst Trauma 2: 169–186Google Scholar
  14. 14.
    Shiogai T (1989) Evaluation of the diagnosis of brain death: Part II. Short-latency somatosensory evoked potentials (in Japanese). Shinkei Kenkyu no Shinpo 33: 507–519Google Scholar
  15. 15.
    Belsh JM, Chokroverty S (1987) Short-latency somatosensory evoked potentials in brain-dead patients. Electroencephalogr Clin Neurophysiol 68: 75–78PubMedCrossRefGoogle Scholar
  16. 16.
    Delestre F, Lonchampt P, Dubas F (1986) Neural generator of P14 farfield somatosensory evoked potential studied in a patient with a pontine lesion. Electroencephalogr Clin Neurophysiol 65: 227–230PubMedCrossRefGoogle Scholar
  17. 17.
    Buchner H, Ferbert A, Hacke W (1988) Serial recording of median nerve stimulated subcortical somatosensory evoked potentials ( SEPs) in developing brain death. Electroencephalogr Clin Neurophysiol 69: 14–23PubMedCrossRefGoogle Scholar
  18. 18.
    Stör M, Riffel B, Trost E, Ullrich A (1987) Short-latency somatosensory evoked potentials in brain death. J Neurol 234: 211–214CrossRefGoogle Scholar
  19. 19.
    Hughes JR (1978) Limitation of the EEG in coma and brain death. Ann NY Acad Sci 315: 121–136PubMedCrossRefGoogle Scholar
  20. 20.
    Bricolo A, Turazzi S, Faccioli F, Odorizzi F, Sciarretta G, Erculiani P (1978) Clinical application of compressed spectral array in long-term EEG monitoring of comatose patients. Electroencephalogr Clin Neurophysiol 45: 211–225PubMedCrossRefGoogle Scholar
  21. 21.
    Grigg MM, Kelly MA, Celesia GG, Ghobrial MW, Ross ER (1987) Electroencephalographic activity after brain death. Arch Neurol 44: 948–954PubMedCrossRefGoogle Scholar
  22. 22.
    Shiogai T (1989) Evaluation of the diagnosis of brain death: Part III. Compressed spectral arrays (in Japanese). Brain Nerve 41: 309–318PubMedGoogle Scholar
  23. 23.
    Siesjö(1984) Cerebral circulation and metabolism. J Neurosurg 60:883–908Google Scholar
  24. 24.
    The Swedish Ministry of Health and Social Affairs (1984) The concept of death. Report of the Swedish committee on defining death, StockholmGoogle Scholar
  25. 25.
    Lindegaard K-F, Grip A, Nornes H (1980) Precerebral haemodynamics in brain tamponade: Part 1. Clinical studies on blood-flow velocity. Neurochirurgia (Stuttg) 23: 133–142Google Scholar
  26. 26.
    Hassler W, Steinmetz H, Gawlowski J (1988) Transcranial Doppler ultrasonography in raised intracranial pressure and in intracranial circulatory arrest. J Neurosurg 68: 745–751PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Toshiyuki Shiogai
  • Kazuo Takeuchi
    • 1
  1. 1.Department of NeurosurgeryKyorin University School of MedicineMitaka, Tokyo, 181Japan

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