Strategies for basic and advanced neuromonitoring techniques are reviewed. Cerebral hyperthermia during rewarming and unrecognized jugular venous obstruction are associated with cerebral compromise and can be readily detected and avoided. The strengths and limitations of transcranial Doppler and electroencephalographic monitoring are reviewed, as is use of noninvasive cerebral optical spectroscopy and jugular venous oximetry. The potential for reduction in perioperative stroke by using epiaortic scanning to detect and avoid otherwise nonpalpable atherosclerotic plaque, is also reviewed.
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