Non-invasive Neuromonitoring: Near Infrared Spectroscopy and Pupillometry

The prevention of secondary injury after Traumatic Brain Injury (TBI) is of paramount importance. Early detection and management of the possible causes of secondary insult could have a huge impact on neurological outcomes. Noninvasive monitoring is rapidly emerging as applicable, and reliable tool for the bedside evaluation and for the rapid detection of neurological complications in patients with Traumatic Brain Injury. Noninvasive neuromonitoring can evaluate cerebral hemodynamics, cerebral oxygen metabolism and cerebral functional state. Indeed, neuromonitoring can be applied for the evaluation of cerebral blood flow, cerebral oxygenation, flow autoregulation and for the estimation of intracranial pressure. Providing a deeper understanding of the dynamic and the evolution of impending neurological complications, neuromonitoring plays a crucial role for a rapid detection of possible secondary insult with the purpose to provide a tailored management. In this chapter, we aimed to provide an overview of the technological feature and of the clinical application of Near-Infrared Spectroscopy and Pupillometry in TBI patients.