When monitors agree, and when they disagree

TBI patient: PRx says intact, COx says impaired. Why?

SAH child day 6: ICP normal, TCD velocity climbing. What now?

Sedated TBI: aEEG narrowing + TCD systolic peaks, what is happening?

Walk through the 4-hour CPPopt computation and how to act on the orange band.

Hypertonic saline bolus: ICP falls, but does the NIRS over- or under-shoot?

VA-ECMO patient: PRx unreliable; what do you trust?

Use of TCD, evoked potentials, and pupillometry alongside the clinical exam.

A bedside flowchart for the most common discordances and what to check first.

PbtO₂ < 18 mmHg, walk the CPP/FiO₂ titration tree.

Cooling protocol day 2: integrate aEEG continuity, NIRS rSO₂, and pupillometry.

New DKA, severe acidosis. Hour 4 of fluids: GCS drops, irritable, headache. What is your monitoring plan?

Convulsive SE → refractory → super-refractory. The cEEG-guided sedation pathway, with multimodal sentinels.

PICU at a regional hospital: ICP probe not available, no continuous EEG. What you can still do, and how.

Sudden hemiparesis at school. Door-to-needle in the pediatric ED, hyperacute monitoring, and the role of NIRS / TCD / cEEG.

Pediatric pneumococcal meningitis, day 2: GCS falling, irritability, suspected raised ICP. The neuromonitoring response.

After brain-death determination cannot be completed (residual cranial-nerve reflex), the family considers DCD. The role of MNM in supporting the conversation and the protocol.

Three real conversations: explaining a "PRx +0.32 trend" to a parent, communicating prognostic uncertainty in HIE, and the post-arrest "what does this number mean for my child" question.

Acute encephalopathy in a child with known POLG mutation. Why microdialysis L/P thresholds, MRI patterns, and clinical exam diverge from the textbook TBI playbook.