Researchers led by the University of Waterloo have developed a new monitoring platform that could transform neurocritical care by detecting infections and drainage complications much earlier than current methods. Called NeuroSense, the system continuously analyzes cerebrospinal fluid (CSF) at the patient's bedside, providing clinicians with near real-time insights into a patient's condition.
The technology has the potential to improve outcomes for patients with severe neurological conditions while reducing healthcare costs. The findings were published in Science Translational Medicine.
Faster detection
Each year, approximately 25,000 patients in the United States alone require external drains to remove excess cerebrospinal fluid caused by conditions such as traumatic brain injury, hydrocephalus, or brain hemorrhage. However, up to 20 percent of these patients develop infections related to the drainage system. Such infections can lead to severe complications, including meningitis, neurological damage, prolonged hospitalization, disability, and even death.
According to lead researcher Professor Mahla Poudineh, Canada Research Chair in Health Monitoring BioNano Devices at the University of Waterloo, early intervention is critical. “This platform is designed to capture trends almost instantly and identify complications before they become significantly more serious,” she explained.
Limitations of current monitoring
Today, clinicians typically rely on periodic sampling of cerebrospinal fluid, which is then sent to a laboratory for analysis. This process is labor-intensive and usually performed only once every one or two days. As a result, important changes in a patient's condition may go unnoticed between testing intervals. This delay can be particularly problematic when infections develop rapidly or when fluid drainage becomes obstructed.
Recognizing this gap, the international research team set out to develop a solution capable of continuously monitoring cerebrospinal fluid and providing immediate feedback to healthcare professionals.
Continuous bedside monitoring
The result is NeuroSense, a compact monitoring platform that connects directly to existing CSF drainage systems. As cerebrospinal fluid flows through the drainage line, integrated sensors continuously measure biomarkers associated with infection. The system monitors glucose, lactate, and pH levels, while also tracking fluid flow rates. Together, these measurements provide early warning signs of both infection and drain malfunction.
The technology is housed in a 3D-printed device approximately the size of a smartphone. Four sensors are connected to an electrochemical analyzer and a display that allows physicians and nurses to monitor patient status continuously at the bedside.
According to lead author Fatemeh Keyvani, a PhD candidate in Electrical and Computer Engineering at Waterloo, this continuous monitoring approach could significantly improve clinical decision-making. “The benefits include early warning of infection or drain malfunction, enabling faster and better treatment decisions,” she said.
Promising early results
In laboratory evaluations and a preliminary clinical study involving intensive care patients, NeuroSense demonstrated performance comparable to conventional testing methods. The major advantage, however, is its ability to provide continuous data rather than intermittent snapshots.
Researchers believe this could help clinicians identify complications sooner, initiate treatment earlier, and potentially prevent severe outcomes. The team is now working on the next stage of development, including the addition of automated alarm functions that would immediately alert healthcare staff when concerning trends are detected. Larger clinical trials are also planned to further validate the technology's effectiveness and support future commercialization efforts.
NeuroSense reflects a broader shift toward continuous, data-driven patient monitoring in critical care environments. By bringing laboratory-style analysis directly to the bedside, the technology could enable more proactive management of vulnerable neurological patients.
The project is a collaboration between the University of Waterloo, University Medicine Rostock in Germany, the Massachusetts Institute of Technology (MIT), and Harvard Medical School. If future clinical studies confirm the current findings, NeuroSense could become an important new tool for improving the safety and quality of neurocritical care worldwide.
Real-time brain monitoring
In 2025, researchers at Erasmus MC's BrainEcho Lab developed an innovative ultrasound-based brain imaging system that can monitor brain activity in real time, even while a patient is walking. The technology, published in Science Advances, captures brain activity at an unprecedented rate of 10,000 images per second, overcoming the limitations of traditional MRI, which requires patients to remain still.
The breakthrough relied on a custom helmet and a skull implant made of PEEK (polyetheretherketone), a material that allows ultrasound waves to pass through with minimal interference. Using this setup, researchers successfully recorded brain activity in a walking patient for the first time. Beyond neuroscience research, the technology could support brain surgery by providing detailed information about cerebral blood flow, helping surgeons identify critical brain regions.
