Research progress on multimodal monitoring combined with biomarkers in critical care management strategies after neurointerventional surgery

Neurointerventional techniques are core treatments for cerebrovascular diseases, yet postoperative complications, including ischemia-reperfusion injury, hyperperfusion syndrome, vasospasm, and delayed cerebral ischemia, remain key factors limiting patient prognosis. Traditional single monitoring modalities are limited by insufficient timeliness, low specificity, and uneven spatial coverage, making them inadequate for precise critical care management after surgery. Recently, the combined application of multimodal neuromonitoring and serum biomarkers has provided a new paradigm for early detection, dynamic staging, precise evaluation, and individualized intervention of brain injury following neurointerventional procedures. This article systematically reviews the application value of intracranial pressure monitoring, transcranial Doppler ultrasound, and near-infrared spectroscopy (NIRS) in assessing cerebral perfusion and oxygenation. It illustrates the complementary roles of Computed tomography (CT)/Magnetic resonance imaging (MRI) imaging combined with biological markers, including S100β protein, neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP), in staging brain injury. It also analyzes advances in the integrated application of brain injury markers, inflammatory markers, and vascular injury markers, and discusses current controversies and cutting-edge directions in technological integration. This review aims to provide theoretical evidence and practical references for optimizing critical care strategies and improving clinical outcomes after neurointerventional surgery.