Skip to main content

Transcranial cerebral oximetry (TCCO) monitoring in neurosurgical critically ill patients


Near-infrared spectroscopy (NIRS) has been used to monitor cerebral oxygenation in various clinical fields. However, its utility has not been demonstrated in more complex situations, such as neurosurgical critically ill patients. The objective of this study was to examine the ability of TCCO to detect cerebrovascular events, such as oligemic hypoxia, relative cerebral hyperemia and vasospasm in neurosurgical critically ill patients with different outcome.


This study involved a retrospective analysis of regional cerebral saturation(rSO2) data collected in 64 neurosurgical patients in critical states using the INVOS 4100 cerebral oximeter as a part of multimodal neuromonitoring. Patients were divided into three groups: group I, good outcome/moderate disability (GOS 5–4, 14 male/four female, 38.9 years old); group II, severe disability/vegetative state (GOS 3–2, 12 male/four female, 37.6 years old); and group III, dead (20 male/10 female, 39.2 years old). The outcome was assessed at discharge of the patients from the hospital.


TCCO monitoring detected a pathological pattern of regional cerebral oxygenation in 83% of patients. In patients with vasospasm, early appearance and increasing rSO2 fluctuations more than 10% were correlated with poor outcome. 74.3% of patients where we monitored both rSO2 and SjbO2 have had the same pattern of increased or decreased parameters (Table 1).

Table 1


As a noninvasive, bedside, nonoperator-dependent tool TCCO is effective in identifying such cerebrovascular events as oligemic cerebral hypoxia, relative cerebral hyperemia and vasospasm, which were more pronounced in neurosurgical patients with unfavorable outcome.

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Toma, G., Amcheslavski, V., Lukianov, V. et al. Transcranial cerebral oximetry (TCCO) monitoring in neurosurgical critically ill patients. Crit Care 7, P081 (2003).

Download citation

  • Published:

  • DOI:


  • Emergency Medicine
  • Retrospective Analysis
  • Critical State
  • Unfavorable Outcome
  • Complex Situation