Electrophysiological monitoring of acute brain injury progression

Continuous monitoring of physiological parameters is now considered as a standard of care in intensive care units (ICU). While there are now multiple techniques available to guide hemodynamic or respiratory management, the monitoring of neurological function in unconscious patients is usually limited to discontinuous bedside neurological examination or morphological brain imaging. However, cortical activity is accessible at the bedside with electroencephalography (EEG), electrocorticography (ECoG). In this lecture we will discuss how those electrophysiological techniques can be used in the ICU to assess neurological function in comatose patients at the acute phase of brain injuries such as traumatic brain injuries, hemorrhagic or ischemic stroke.

Learning Objectives:

• Know the electrophysiological markers of cortical injury
• Define a monitoring strategy after severe traumatic brain injury, under deep sedation, following subarachnoid hemorrhage.