Noninvasive Neuromonitoring

All neuromonitoring tools were initially developed to either augment or supplant the neurological exam when the effects of treatment or the brain insult itself mask clinical findings. Some monitoring tools have become as essential as the clinical exam in the care of neurocritically ill patients and are used routinely to assess cerebral hemodynamics and function, such as transcranial Doppler ultrasonography and evoked potential monitoring. Other tools, such as near-infrared spectroscopy, processed electroencephalography, and point-of-care electroencephalography, are not yet standards of practice in the management of patients with critical neurological illness. Yet, all three represent systems that can be rapidly applied at the bedside without the need for specialized technicians or complex procedures to operate the equipment. The ongoing development of integrated multimodality neuromonitoring drives the evolution of neurocritical care toward individualized therapeutic decision-making to improve neurological recovery.