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Review article
Available online 23 September 2025
Noninvasive bedside neuromonitoring in acute brain injury. A narrative review
Neuromonitorización no invasiva a pie de cama en la lesión cerebral aguda. Una revisión narrativa
Daniel Agustín Godoya, Jon Pérez-Bárcenab, Francisco de Paula Delgado-Moyac, Jesús Abelardo Barea-Mendozac, Juan Antonio Llompart-Poub,
a Unidad de Cuidados Neurointensivos, Sanatorio Pasteur, San Fernando del Valle de Catamarca, Argentina
b Servei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Spain
c UCI trauma y emergencias, Hospital Universitario 12 de Octubre, Madrid, Spain
Received 23 June 2025. Accepted 04 September 2025
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Table 1. Potential use of Continuous EEG in neurocritical care.
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Table 2. Advantages and limitations of noninvasive, bedside neuromonitoring.
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Abstract

Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization.

Keywords:
Acute brain injury
Noninvasive neuromonitoring
Neurocritical care
Transcranial ultrasound
Near-infrared spectroscopy
Automated pupillometry
Electroencephalogram
Intracranial pressure
Waveform analysis
Resumen

El examen neurológico clínico sigue siendo el patrón oro para detectar, diagnosticar y realizar el seguimiento de las respuestas al tratamiento en el paciente neurocrítico. Sin embargo, en pacientes con déficits neurológicos graves al inicio o en aquellos que requieren sedantes, detectar el deterioro neurológico puede ser un reto. En este escenario, la neuromonitorización no invasiva a pie de cama como parte de estrategias multimodales puede ser útil para evitar lesiones cerebrales secundarias y para seleccionar qué paciente con lesión cerebral aguda se beneficiaría de una neuromonitorización invasiva.

Palabras clave:
Lesión cerebral aguda
Neuromonitorización no invasiva
Cuidados neurocríticos
Ecografía transcraneal
Espectroscopia del infrarrojo cercano
Pupilometría automatizada
Electroencefalograma
Presión intracraneal
Análisis de forma de onda

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