Intracranial hypertension is a life-threatening condition that if left unchecked can lead to brain herniation, cerebral ischemia, and brain death. Intracranial pressure (ICP) monitoring is frequently helpful for patient management. If placed, the monitor should be inserted in comatose patients at high risk for elevated ICP. ICP values, trends, and waveforms should be analyzed in conjunction with cerebral perfusion pressure (CPP) to guide therapy. Patients with elevated ICP can be managed using a tiered strategy that emphasizes cerebral spinal fluid drainage, sedation, and CPP optimization (tier one) prior to initiating bolus osmotherapy, hyperventilation, or paralysis (tier two). Multimodality monitoring therapy is a promising strategy that can detect secondary brain injury early and allow individualized treatment. Tier-three strategies for superrefractory ICP elevation include decompressive craniectomy, hypothermia, and pentobarbital infusion. Of these, craniectomy appears to be the most effective measure for reducing mortality, especially in younger patients.

Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event with profound effects on the central nervous system and several other organs, and is defined by bleeding into the subarachnoid space between the arachnoid layer and pia mater. SAH occurs with an incidence of 2–22.5 per 100,000 [1,2]. The highest reported incidences of aneurysmal SAH (aSAH) come from Japan and Finland and occur at a rate of 16–22.5 per 100,000 per year. In the United States, SAH occurs at approximately 6 per 100,000, or a total of 18,000 events per year. The incidence of aSAH peaks in the 55–60-year-old age group. Additionally, subarachnoid hemorrhage is a consequence of traumatic brain injury in 12–53%, which corresponds to approximately 240,000 persons per year in the United States.

Over the last decades, high-throughput screening (HTS) of small molecule libraries has developed into a very powerful tool for drug discovery. Although HTS capabilities initially were developed almost exclusively in the domain of pharmaceutical and biotech commercial ventures, they have more recently become available in academia. The Molecular Library Initiative of the National Institutes of Health (NIH) is one example that HTS has established itself as a routine technology in biomedical research [1].

The popularity of HTS is due to rapid developments in four different areas:

1. Robotic systems. Once exotic and expensive, robotic systems and automatic liquid handling have become more affordable and easier to operate. Turnkey systems are available for the most common applications.

2. Chemical libraries. Chemical libraries are becoming more readily available and affordable to the scientific community in academia and industry. Even large compound libraries, such as the one developed for the above-mentioned Molecular Library Initiative, are accessible to the general scientific community.

3. Plate reader platforms. Reader platforms have undergone rapid development over the last two decades. As of today, high-speed microplate readers are available to very rapidly scan microplates in the 96-, 384-, and 1536-well formats or even higher densities. Automated confocal and conventional microscopes and other image-based reader platforms have evolved at an astonishing speed. Sophisticated image-based readers and corresponding image recognition and analysis software have led to the development of complex, high-content cell-based assays.

4. Detection technologies. A whole array of luminescence-based technologies have been developed and commercialized over the last few years. Among those are fluorescent proteins, high-yield fluorochromes, and luminescence substrates.