Theoretical description of the fundamentals of the ideal multimodal brain and spinal cord metabolism and function monitoring

Point 1: Global or segmental investigation of the central nervous system (CNS) with the possibility of individual adaptation following each case request

Point 2: Similar physiological dimension of the neurological indicators in comparison to the physiological hemodynamic or respiratory parameters—no calculation, no index

Point 3: Early detection of possible deterioration of neural function before definitive damage, because the sooner neural dysfunction is detected, the more reversible it is (usefulness of trends)

Point 4: Multimodality

Point 5: Subclinical detection of physiological or pathophysiological changes before the occurrence of major and definitive consequences to guide the earliest possible intervention to reduce and/or inverse the neural suffering, to improve the vital and functional prognosis of the patients by limiting the impact on the brain, spinal cord, or both

Point 6: Monitoring the versatility of either cerebral pathophysiology (stroke, ischaemia, haemorrhage, seizures, etc.) or pharmacological interaction (anaesthesia, barbiturates, anti-epileptic drugs, etc.)

Point 7: Make as much as possible the distinction between the anesthesiology and the effects of surgery on the pathophysiological process

Point 8: Make concrete not only CNS metabolism but also CNS function to make easier the management of anesthetised patients during the intraoperative period or comatose patients during their intensive care unit stay

Point 9: Apply the precepts of telemedicine and telemonitoring