Review Article| Volume 35, ISSUE 1, P83-94, March 2023

Invasive Neuromonitoring in the Stroke Patient

Published:January 02, 2023DOI:


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Critical Care Nursing Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Brain Trauma Foundation
        • American Association of Neurologic Surgeons
        • Congress of Neurologic Surgeons
        • et al.
        Guidelines for the management of severe traumatic brain injury VI: indications for intracranial pressure monitoring.
        J Neurotrauma. 2007; 24: S37-S44
        • Chestnut R.
        • Videtta W.
        • Vespa P.
        • et al.
        Intracranial pressure monitoring: Fundamental considerations and rationale for monitoring.
        Neurocrit Care. 2014; 21: S64-S84
        • Chen H.
        • Stiefel M.
        • Oddo M.
        • et al.
        Detection of cerebral compromise with multimodality monitoring in patients with subarachnoid hemorrhage.
        Neurosurgery. 2011; 69: 53-63
        • Olson D.
        • Kofke W.
        • O’Phelan K.
        • et al.
        Global monitoring in the neurocritical care unit.
        Neurocrit Care. 2015; 22: 333-347
        • Fan J.-L.
        • Nogueira R.C.
        • Brassard P.
        • et al.
        Integrative physiological assessment of cerebral hemodynamics and metabolism in acute ischemic stroke.
        J Cereb Blood Flow Metab. 2021; 423: 454-470
        • Censullo J.
        • Firikh A.
        • Mulkey M.
        • et al.
        Nursing care of the patient with aneurysmal subarachnoid hemorrhage. AANN clinical practice guideline series.
        American Association of Neuroscience Nurses, Glenview (IL)2018
        • Veldeman M.
        • Albanna W.
        • Weiss M.
        • et al.
        Invasive multimodal neuromonitoring in aneurysmal subarachnoid hemorrhage: a systematic review.
        Stroke. 2021; 52: 3624-3632
        • Kieninger M.
        • Meichelbock K.
        • Bele S.
        • et al.
        Brain multimodality monitoring in patients suffering from acute aneurysmal subarachnoid hemorrhage: clinical value and complications.
        J Integ Neurosci. 2021; 20: 703
        • Michels D.M.
        • Van Dijk L.C.
        • Tavy D.L.
        Perioperative stroke during carotid endarterectomy: benefits of multimodal neuromonitoring - a case report.
        BMC Neurol. 2022; 22
        • Le Roux P.
        • Menon D.K.
        • Citerio G.
        • et al.
        Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care.
        Neurocrit Care. 2014; 21: 1-26
        • Kleindorfer D.O.
        • Towfighi A.
        • Chaturvedi S.
        • et al.
        2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association.
        Stroke. 2021; 52: e364-e367
        • Zhong W.
        • Ji Z.
        • Sun C.
        A review of monitoring methods for cerebral blood oxygen saturation.
        Healthcare. 2021; 9: 1104
        • Veldeman M.
        • Albanna W.
        • Weiss M.
        • et al.
        Treatment of delayed cerebral ischemia in good-grade subarachnoid hemorrhage: a role for invasive neuromonitoring?.
        Neurocrit Care. 2021; 35: 172-183
        • Kirkman M.A.
        • Smith M.
        Multimodal neuromonitoring.
        Anes Clin. 2016; 34: 511-523
        • Yang Y.
        • Chang T.
        • Luo T.
        Multimodal monitoring for severe traumatic brain injury.
        Neurosurgery. 2017; 23: 1346-1349
        • Tasneem N.
        • Samaniego E.A.
        • Pieper C.
        • et al.
        Brain multimodality monitoring: a new tool in neurocritical care of comatose patients.
        Crit Care Res Prac. 2017; (Article ID 6097265)
        • Fiore M.
        • Bogossian E.
        • Creteur J.
        • et al.
        Role of brain tissue oxygenation (PbtO2) in the management of subarachnoid haemorrhage: a scoping review protocol.
        BMJ Open. 2020; 10: e35521
        • Goyal K.
        • Khandelwal A.
        • Kedia S.
        Multimodal neuromonitoring: current scenario in neurocritical care.
        J Neuroanaesthesiology Crit Care. 2019; 6: 062-071
        • Chestnut R.
        • Temkin N.
        • Carney N.
        • et al.
        A trial of intracranial-pressure monitoring in traumatic brain injury.
        N Engl J Med. 2012; 367: 2471-2481
        • Ruhatiya R.S.
        • Adukia S.A.
        • Manjunath R.B.
        • et al.
        Current status and recommendation in multimodal neuromonitoring.
        Indian J Crit Care Med. 2020; 24: 353-360
        • Livesay S.L.
        The bedside nurse: the foundation of multimodal neuromonitoring.
        Crti Care Nurs Clin N Am. 2016; 28: 1-8
        • March K.
        • Madden L.
        Intracranial pressure management.
        in: Littlejohns L.R. Bader M.K. AACN-AANN protocols for practice: monitoring technologies in critically ill neuroscience patients. Jones and Bartlett, Sudbury (Ontario)2009: 35-69
        • Hinkle J.L.
        • Heck C.
        Monitoring for neurologic dysfunction.
        in: Booker K.J. Critical care nursing: monitoring and treatment for advanced nursing practice. Wiley Blackwell, Ames (IA)2015: 87-103
        • Zrelak P.A.
        • Eigsti J.
        • Fetzick A.
        • et al.
        Evidence-based review: nursing care of adults with severe traumatic brain injury. AANN clinical practice guideline series.
        American Association of Neuroscience Nurses, Glenview (IL)2020
        • Greenberg S.M.
        • Ziai W.C.
        • Cordonnier C.
        • et al.
        2022 Guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association/American Stroke Association.
        Stroke. 2022; 53
        • Lara L.R.
        • Puttgen H.A.
        Multimodality monitoring in the neurocritical care unit. Continuum.
        Lifelong Learn Neurol. 2018; 24: 1776-1788
        • Roh D.
        • Park S.
        Brain multimodality monitoring: updated perspectives.
        Curr Neurol Neurosci Rep. 2016; 16: 56
        • Vinciguerra L.
        • Bosel J.
        Noninvasive neuromonitoring: current utility in subarachnoid hemorrhage, traumatic brain injury, and stroke.
        Neurocrit Care. 2017; 27: 122-140
        • Richter J.
        • Sklienda P.
        • Chatterjee N.
        • et al.
        Elevated jugular venous oxygen saturation after cardiac arrest.
        Resuscitation. 2021; 169: 214-219
        • Oddo M.
        • Hutchinson P.J.
        Understanding and monitoring brain injury: the role of cerebral microdialysis.
        Intensive Care Med. 2018; 44: 1945-1948
        • Muralidharan R
        External ventricular drains: management and complications.
        Surg Neurol Int. 2015; 6: S271-S274
        • Morone P.
        • Dewan M.
        • Zuckerman S.L.
        • et al.
        Craniometrics and ventricular access: a review of Kocher's, Kaufman's, Paine's, Menovksy's, Tubbs’, Keen's, Frazier's, Dandy's, and Sanchez's Points.
        Oper Neurosurg. 2020; 18: 461-469
        • Greenberg MS
        Operations and procedures.
        in: Handbook of neurosurgery. 7th edition. Thieme, New York2010: 207-214
        • Leeper B.
        • Lovasik D.
        Cerebrospinal drainage systems: external ventricular and lumbar drains.
        in: Littlejohns L.R. Bader M.K. AACN-AANN protocols for practice: monitoring technologies in critically ill neuroscience patients. Jones and Bartlett, Sudbury (Ontario)2009: 71-82
        • Fried H.I.
        • Nathan B.R.
        • Rowe A.S.
        • et al.
        The insertion and management of external ventricular drains: an evidence-based consensus statement.
        Neurocrit Care. 2016; 24: 61-81
        • Rajshekhar V.
        • Harbaugh R.E.
        Results of routine ventriculostomy with external ventricular drainage for acute hydrocephalus following subarachnoid haemorrhage.
        Acta Neurochir. 1992; 115: 8-14
        • Hasan D.
        • Vermeulen M.
        • Wijdicks E.F.
        • et al.
        Management problems in acute hydrocephalus after subarachnoid hemorrhage.
        Stroke. 1989; 20: 747-753
        • Kuo L.T.
        • Huang A.P.-H.
        The pathogenesis of hydrocephalus following aneurysmal subarachnoid hemorrhage.
        Int J Mol Sci. 2021; 22: 5050
        • Vespa P.
        • Menon D.
        • LeRoux P.
        • et al.
        Participants in the international multidisciplinary consensus conference on multimodality monitoring. The international multi-disciplinary consensus conference on multimodality monitoring: future directions and emerging technologies.
        Neurocrit Care. 2014; 21: S270-S281
        • Okonkwo D.O.
        • Shutter L.A.
        • Moore C.
        • et al.
        Brain oxygen optimization in severe traumatic brain injury phase-II: a phase II randomized trial.
        Crit Care Med. 2017; 45: 1907-1914
        • Shafi S.
        • Barnes S.A.
        • Millar D.
        • et al.
        Suboptimal compliance with evidence-based guidelines in patients with traumatic brain injuries.
        J Neurosurg. 2014; 120: 773-777
        • Yuan Q.
        • Xing W.
        • Yirui S.
        • et al.
        Impact of intracranial pressure monitoring on mortality in patients with traumatic brain injury: a systematic review and meta-analysis.
        J Neurosurg. 2015; 122: 574-587