Chapter
INTRODUCTION TO MONITORING TECHNIQUES
1 - Intracranial Pressure Monitoring
External Ventricular Drainage
Epidural and Subdural Devices
Intraparenchymal Microtransducers
INVASIVE READINGS AND INTERPRETATION
Index of Pressure-Volume Compensatory Reserve (RAP)
EFFECT OF ANESTHETICS ON INTRACRANIAL PRESSURE
CURRENT EVIDENCE, APPLICATIONS, AND DISCUSSION
2 - Cerebral Blood Flow Monitoring
CEREBRAL METABOLIC PARAMETERS3,4
Viscosity Autoregulation6,9-11
Flow Metabolism Coupling1,12
IMPORTANCE OF CBF MONITORING
Indirect Measurement Techniques
Neurological Examination2
Neurophysiologic Monitoring14,15
Transcranial Doppler17-19
Laser Doppler Flowmetry18,21,22
Thermal Diffusion Flowmetry18,23,24
Near-Infrared Spectroscopy25,26
Jugular Venous Saturation19,26-29
Brain Tissue Oxygen Monitoring26,27,30
Direct Measurement Techniques
Fick's Equation-Based Techniques2,19
Jugular Venous Thermodilution19
Neuroimaging-Based Direct Measurement Techniques26,35,36
Computerized Tomography Perfusion
Xenon-Enhanced Computer Tomography
Positron Emission Tomography
Single Photon Emission Computed Tomography
3 - Jugular Venous Oximetry
Anatomy of Venous Drainage of the Brain
Jugular Venous Oxygen Saturation (SjvO2)
UNDERSTANDING THE EQUIPMENT
Jugular Bulb Monitoring Equipment
Jugular Bulb Catheter Placement
Side of Jugular Bulb Monitoring
Continuous Monitoring of SjvO2 Versus Intermittent Sampling
INDICATIONS AND CONTRAINDICATIONS
Aneurysmal Subarachnoid Hemorrhage (SAH)
Intracranial Arteriovenous Malformation (AVM)
Intraoperative Use of Jugular Venous Monitoring
Contraindications and Complications of Jugular Bulb Catheter Monitoring
READINGS AND INTERPRETATION
Volatile Anesthetic Agents
ADVANTAGES AND DISADVANTAGES
4 - Electroencephalography-Based Monitors
Processed Electroencephalography
Time and Frequency Domain Analyses
Disorder Within the Electroencephalogram
Depth of the Hypnotic Component of Anesthesia Monitoring
The Bispectral Index (BIS™)
Spectral Entropy of the EEG (GE Datex-Ohmeda Entropy™, GE Healthcare, Milwaukee, WI, USA)
The Patient State Index (PSI)
The Cerebral State Index (CSI)
The Wavelet-Based Anesthetic Value for Central Nervous System Monitoring (WAVCNS)
The Cortical State and the Composite Cortical State
Nociception-Antinociception Balance Monitoring
The Composite Variability Index
The Gradient Between State and Response Entropy
The Gamma-Band Oscillation Power and High Frequencies of the Electroencephalogram
Auditory Evoked Potentials
Transcranial Magnetic Stimulation
UNDERSTANDING THE EQUIPMENT
Raw and Processed Electroencephalography
Depth of Anesthesia Monitoring
Transcranial Magnetic Stimulation
INDICATIONS AND CONTRAINDICATIONS
Raw and Processed Electroencephalography
Depth of the Hypnotic Component of Anesthesia Monitoring
Nociception-Antinociception Balance Monitoring
The Gradient Between State and Response Entropy (RE-SE)
Gamma-Band Oscillation Power
Transcranial Magnetic Stimulation
READINGS AND INTERPRETATION
Raw and Processed Electroencephalography
Depth of the Hypnotic Component of Anesthesia Monitoring
Transcranial Magnetic Stimulation and Perturbational Complexity Index
Raw and Processed Electroencephalography
Depth of the Hypnotic Component of Anesthesia Monitoring
ADVANTAGES AND DISADVANTAGES
Raw and Processed Electroencephalography
Depth of the Hypnotic Component of Anesthesia Monitoring
Nociception-Antinociception Balance Monitoring
Gradient Between State and Response Entropy (RE-SE Gradient)
The Gamma-Band Oscillation Power
Raw and Processed Electroencephalography
Depth of the Hypnotic Component of Anesthesia Monitoring
Nociception-Antinociception Balance Monitoring
5 - Transcranial Doppler Ultrasonography
UNDERSTANDING THE EQUIPMENT
Machine and Display (Fig. 5.2)
Probe Fixation Devices (Fig. 5.4)
PERFORMING TCD EXAMINATION
READINGS AND INTERPRETATION
Indices of Cerebrovascular Resistance (CVR)
Assessment of Cerebral Autoregulation
Assessment of Cerebrovascular Reactivity to Carbon Dioxide (CRCO2)
Emboli Monitoring (Fig. 5.8)
Noninvasive Estimation of Intracranial Pressure (ICP) and Cerebral Perfusion Pressure
CLINICAL APPLICATIONS OF TCD ULTRASONOGRAPHY (TABLE 5.3)
Vasospasm Following Aneurysmal Subarachnoid Hemorrhage (SAH)
Carotid Endarterectomy (CEA)
Intraoperative TCD Monitoring for CEA
Postoperative TCD Monitoring for CEA
Resection/Embolization of Arteriovenous Malformations (AVMs)
Cerebral Circulatory Arrest
Diagnosis of Right-to-Left Shunts
ADVANTAGES AND DISADVANTAGES
6 - Evoked Response Monitoring
General Overview of Monitoring
Auditory Brainstem Response
Monitoring Other Cranial Nerves
Somatosensory Evoked Potentials
Other Specialized EMG Responses
UNDERSTANDING THE EQUIPMENT
Stimulation, Wiring, and Connections
Recording, Electrical Contaminations, and Storage
INDICATIONS AND CONTRAINDICATIONS
Monitoring and Mapping for Brain Tumors
Monitoring for Cerebral Vascular Lesions
Intracranial Vascular Surgery
Interventional Vascular Procedures
Monitoring Spinal Corrective Surgery
Intramedullary Spinal Tumors
Monitoring the Lumbosacral Spine
Thoracic Aorta Aneurysm Surgery
Contraindication for Monitoring
Effects of Inhalation Agents
Effects of Intravenous Agents
Effects of Adjunct Medications
READINGS AND INTERPRETATION
ADVANTAGES AND DISADVANTAGES
7 - Near-Infrared Spectroscopy
TYPES OF NEAR-INFRARED SPECTROSCOPY SYSTEMS
Continuous Wave Near-Infrared Spectroscopy
Second Derivative Near-Infrared Spectroscopy
Spatially Resolved Near-Infrared Spectroscopy
Time Domain Near-Infrared Spectroscopy
Frequency Domain Near-Infrared Spectroscopy
Functional Near-Infrared Spectroscopy
NEAR-INFRARED SPECTROSCOPY DEVICES
Comparison Between Different Near-Infrared Spectroscopy Machines
Comparison of Cerebral Near-Infrared Spectroscopy and Jugular Bulb Oxygen Saturation
Differences Between Near-Infrared Spectroscopy and Pulse Oximetry
QUANTITATIVE AND NONQUANTITATIVE NEAR-INFRARED SPECTROSCOPY
READING AND INTERPRETATION: THE MONTREAL HEART INSTITUTE ALGORITHM
Artifactual Brain Desaturation
Unilateral Brain Desaturation
Bilateral Brain Desaturation
Bilateral Isolated Brain Desaturation
Bilateral and Regional Brain Desaturation
Bilateral and Global Brain Desaturation
ADVANTAGES OF NEAR-INFRARED SPECTROSCOPY
LIMITATIONS OF NEAR-INFRARED SPECTROSCOPY
CURRENT OPINION: ROLE IN VARIOUS SITUATIONS
Intensive Care Unit, Emergency Room, and Cardiology Suite
Circulatory and Cardiac Arrest
Cognitive Dysfunction and Delirium
Combination Cerebral and Somatic Oximetry
Near-Infrared Spectroscopy Simulation and Modeling
CONCLUSION AND FUTURE DEVELOPMENTS
UNDERSTANDING THE EQUIPMENT
INDICATIONS AND CONTRAINDICATIONS
ADVANTAGES AND DISADVANTAGES
9 - Brain Tissue Oxygenation
Reflectance Spectrophotometry
Near-Infrared Reflectance Spectroscopy
Positron Emission Tomography
Magnetic Resonance Spectroscopy and Magnetic Resonance Imaging
UNDERSTANDING THE EQUIPMENT
Reflectance Spectrophotometry
Near-Infrared Reflectance Spectroscopy
INDICATIONS AND CONTRAINDICATIONS
Reflectance Spectrophotometry
Near-Infrared Reflectance Spectroscopy
READINGS AND INTERPRETATION
Reflectance Spectrophotometry
Near-Infrared Reflectance Spectroscopy
Reflectance Spectrophotometry
Near-Infrared Reflectance Spectroscopy
ADVANTAGES AND DISADVANTAGES
Reflectance Spectrophotometry
Near-Infrared Reflectance Spectroscopy
SjvO2 in Various Conditions27
NIRS in Various Conditions
Oxygen Electrode Versus Optode
PtbO2 in Various Conditions6
Current Evidence for Vasospasms in SAH
Current Evidence for Brain Ischemia
Summary of Current Evidence
10 - Cognitive Function Monitoring
TIMING, OR WHEN TO START?
TOOLS TO ASSESS IN THE EARLY POSTOPERATIVE PERIOD
RIKER AGITATION-SEDATION SCALE56
PERIOPERATIVE NEUROPSYCHOLOGICAL TESTING
11 - Functional MR Imaging
HISTORY OF FUNCTIONAL MAGNETIC RESONANCE IMAGING
WHAT IS FUNCTIONAL MAGNETIC RESONANCE IMAGING?
PRACTICAL ASPECTS OF FUNCTIONAL MAGNETIC RESONANCE IMAGING: HOW IS THE DATA COLLECTED
Hardware Required for Functional Magnetic Resonance Imaging
HOW IS AN FUNCTIONAL MAGNETIC RESONANCE IMAGING CARRIED OUT?11
OTHER SIGNALS STUDIED IN FUNCTIONAL MAGNETIC RESONANCE IMAGING
FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDIES
FUNCTIONAL MAGNETIC RESONANCE IMAGING DATA ANALYSIS
FUNCTIONAL MAGNETIC RESONANCE IMAGING ANESTHESIA STUDIES
CORTICAL EFFECTS OF ANESTHESIA
FUNCTIONAL MAGNETIC RESONANCE IMAGING IN CLINICAL PRACTICE
Functional Magnetic Resonance Imaging in Clinical Practice45,46
Neuromonitoring Techniques
：Quick Guide for Clinicians and Residents
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
