Bedside monitoring of vascular mechanisms in cns trauma: The use of near-infrared spectroscopy (NIRS) and transcranial doppler (TCD)

Abstract

Ischemia and adequacy of regional and global cerebral blood flow are important determinants of outcome in traumatic brain injury (TBI). Although brain ischemia may be a major common pathway of secondary brain damage following TBI, hyperemia and reperfusion injury may also occur and lead to elevated intracranial pressure and decreased cerebral perfusion pressure. Bedside monitors of cerebral ischemia include near-infrared spectroscopy (NIRS), transcranial Doppler ultrasound (TCD), continuous electroencephalography, and brain tissue microdialysis. This chapter will describe how NIRS and TCD enhance our understanding of vascular pathology following a brain injury and their potential applications in the acute management of TBI.