- Over the past few decades, intracranial monitoring technologies focused on treating and preempting secondary injury after traumatic brain injury (TBI) have experienced considerable growth. A physiological measure fundamental to the management of these patients is cerebral blood flow (CBF), which may be determined directly or indirectly. Direct measurement has proven difficult previously; however, invasive and non-invasive CBF monitors are now available. This article reviews the history of CBF measurements in TBI as well as the role of CBF in pathologies associated with TBI, such as cerebral autoregulation, hyperemia, and cortical spreading depression. The limitations of various CBF monitors are reviewed in order to better understand their role in TBI management.