Research Topic

Monitoring Pathophysiology in the Injured Brain

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Acquired cerebral pathologies, ranging from spontaneous hemorrhages or thrombo-embolic incidents to traumatic injuries, are common causes of morbidity and mortality. Following the primary event which leads to cellular death, secondary insults often follows which may exacerbate conditions for surviving ...

Acquired cerebral pathologies, ranging from spontaneous hemorrhages or thrombo-embolic incidents to traumatic injuries, are common causes of morbidity and mortality. Following the primary event which leads to cellular death, secondary insults often follows which may exacerbate conditions for surviving cerebral tissue and lead to secondary permanent lesions. In order to prevent the development of these detrimental cascades, patients are often treated at specialized neuro-intensive care units (NICUs) where multi-modal monitoring is possible. By receiving and analyzing data from physiological parameters, it is possible for the treating physician to detect potential deterioration and individualize and optimize treatment for the individual patient.

The technological development in the field of intracranial monitoring the last decades has been immense. From initially focusing only on intracranial pressure, local treatment algorithms today may include parameters such as cerebral oxygen saturation, metabolism, blood-flow, inflammation as well as advanced radiological examinations, coagulation and brain specific proteins in order to monitor treatment efficacy.

In order to fully understand the complex interplay between factors in the injured brain, we need to be better at incorporating more monitoring modalities of these patients. Both real-time, high resolution monitoring together with intermittent monitoring of injury pathophysiology are essential in the modern NICU as it may be used to detect deterioration, guide treatment and be a surrogate marker of efficacy for new treatment strategies. Multi-center guidelines need to be generated in order for NICUs around the world to swiftly implement new discoveries in this field.

Thus, we encourage clinicians and researchers to share their expertise in this field and how they specifically monitor different modalities in their unconscious patients. Original research articles, review articles, clinical case studies, hypothesis and theory articles, method articles, opinion articles, or technology reports are welcome. We wish to address questions such as the intracranial pressure versus cerebral perfusion pressure debate, how the neuroinflammatory cascades in the injured brain is monitored, how coagulopathies in brain injured patients may be monitored using novel techniques and how protein biomarkers may assist in patient monitoring.


Keywords: Brain Injury, intracranial monitoring, neuroinflammation, neuroradiology, neuro-intensive care, neuro-critical care


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