Optical approaches for neurocritical care: Toward non-invasive recording of cerebral physiology in acute brain injury.

Acute brain injury (ABI) is a complex disease process that begins with an initial insult followed by secondary injury resulting from disturbances in cerebral physiology. In the metabolically active brain, early recognition of physiologic derangements is critical in enabling clinicians with the insight to adjust therapeutic interventions and reduce risk of ischemia and permanent injury. Current established approaches for monitoring cerebral physiology include the neurologic physical examination, traditional brain imaging such as computed tomography (CT) and magnetic resonance imaging (MRI), electroencephalography (EEG), and bedside modalities such as invasive parenchymal probes and transcranial doppler ultrasound.

Evolving concepts in intracranial pressure monitoring - from traditional monitoring to precision medicine.

A wide range of acute brain injuries, including both traumatic and non-traumatic causes, can result in elevated intracranial pressure (ICP), which in turn can cause further secondary injury to the brain, initiating a vicious cascade of propagating injury. Elevated ICP is therefore a neurological injury that requires intensive monitoring and time-sensitive interventions. Patients at high risk for developing elevated ICP undergo placement of invasive ICP monitors including external ventricular drains, intraparenchymal ICP monitors, and lumbar drains.

High-resolution transcranial optical imaging of in vivo neural activity.

Rapid sub-nanometer neuronal deformations have been shown to occur as a consequence of action potentials in vitro, allowing for optical registration of discrete axonal and synaptic depolarizations. Such optically-measured deformations are a novel signature for recording neural activity. We demonstrate this signature can be extended to in vivo measurements through recording of rapid neuronal deformations on the population level with holographic, optical phase-based recordings.

Use of intraosseous hypertonic saline in critically ill patients.

Background: Rapid administration of hypertonic saline 23.4% is crucial in treatment of herniation syndromes. Hypertonic 23.