Review ArticleMonitoring of the central nervous systemWerner, Christian; Kochs, EberhardAuthor Information Department of Anaesthesiology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany Correspondence to Dr Christian Werner, Department of Anaesthesiology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany Tel: +49 89 4140 4291; fax: +49 89 4180 4886; e-mail: [email protected] Abbreviations BIS: bispectral index CBF: cerebral blood flow CNS: central nervous system ECT: electroconvulsive therapy EEG: electroencephalogram MEP: motor evoked potential MLAER: middle-latency auditory evoked responses NIRS: near-infrared spectroscopy SAH: subarachnoid haemorrhage SjO2: jugular bulb venous oxygen saturation TCD: transcranial Doppler sonography Current Opinion in Anaesthesiology: October 1998 - Volume 11 - Issue 5 - p 459-465 Buy Abstract Clinical studies have shown a close relationship between variables such as hypoxia, increased intracranial pressure, arterial hypotension, or seizures and neurological outcome. This indicates the need for monitoring techniques of the central nervous system including measurements of cerebral blood flow, cerebral oxygenation and neuronal function. Semiquantitative changes in cerebral blood flow can be measured continuously using transcranial Doppler sonography. Measurements of jugular venous oxygen saturation or tissue oxygenation reflect the balance between cerebral oxygen delivery and cerebral oxygen demand. Near-infrared spectroscopy appears to be a technology with potential for non-invasive measurements of cerebral oxygen saturation and mitochondrial oxygen availability. The current technology is, however, of limited clinical utility. Brain electrical monitoring techniques such as electroencephalogram and evoked potentials are sensitive and specific to detect changes in neuronal function caused by cerebral ischaemia. Electroencephalogram and evoked potential measurements of depth of anaesethsia and specific electroencephalogram patterns for pharmacodynamic quantification of drug effects may gear the dosage of anaesthetics according to the anaesthetic effect. © 1998 Lippincott Williams & Wilkins, Inc.