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Neurol Res Int. 2013;2013:987934. doi: 10.1155/2013/987934. Epub 2013 Mar 31.

Invasive and noninvasive multimodal bedside monitoring in subarachnoid hemorrhage: a review of techniques and available data.

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Department of Neurology, University of Southern California, Health Sciences Campus, CHP 209 D, Mail Code 9207, Los Angeles, CA 90089-9207, USA.


Delayed-cerebral ischemia is a major cause of morbidity and mortality in the setting of aneurysmal subarachnoid hemorrhage. Despite extensive research efforts and a breadth of collective clinical experience, accurate diagnosis of vasospasm remains difficult, and effective treatment options are limited. Classically, diagnosis has focused on imaging assessment of the cerebral vasculature. Recently, invasive and noninvasive bedside techniques designed to characterize relevant hemodynamic and metabolic alterations have gained substantial attention. Such modalities include microdialysis, brain tissue oxygenation, jugular bulb oximetry, thermal diffusion cerebral blood flow, and near-infrared spectroscopy. This paper reviews these modalities and examines data pertinent to the diagnosis and management of cerebral vasospasm.

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