Role of multimodal monitoring in the management of patients undergoing complex intracranial bypass procedures – A case series and literature review

Abstract

Patients undergoing complex intracranial neurovascular procedures continue to have a high mortality rate. Individualised goal-directed cerebral resuscitation employing multimodality neuromonitoring may impact these patients' treatment and prognosis. Advanced monitoring methods aid in the early identification of secondary brain insults and serve as endpoints for goal-directed therapy in the perioperative period. Unfortunately, there is a paucity of literature exploring the impact of multimodality monitoring and its outcome in these patients. We aim to present this case series wherein the patients had a favourable outcome post-intracranial complex bypass procedure, owing to goal-directed management guided by multimodality monitoring in the perioperative period.

Keywords

• complex intracranial aneurysm
• intracranial near-infrared spectroscopy
• jugular oximetry
• patient state index
• transcranial doppler