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These infections pose significant risks to patient outcomes due to delayed diagnosis, escalating antimicrobial resistance, and limited therapeutic efficacy. Conventional diagnostic approaches, such as cerebrospinal fluid (CSF) analysis, microbial cultures, and neuroimaging, exhibit notable limitations in sensitivity, specificity, and rapidity. This review highlights transformative technologies reshaping PCNSI diagnostics, including molecular assays (e.g., quantitative PCR, digital droplet PCR), metagenomic next-generation sequencing (mNGS), CRISPR-based pathogen detection platforms, metabolomics, and advanced molecular imaging modalities. Furthermore, we address translational challenges in clinical adoption, including cost barriers, standardization gaps, and the need for interdisciplinary collaboration. Emerging artificial intelligence (AI)-driven strategies are proposed to optimize pathogen identification, predict antimicrobial resistance profiles, and tailor personalized therapeutic regimens.<\/jats:p>","DOI":"10.1007\/s10072-025-08279-4","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T01:50:55Z","timestamp":1748829055000},"page":"4279-4291","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Recent advances in diagnostic technologies for postoperative central nervous system infections: a review"],"prefix":"10.1007","volume":"46","author":[{"given":"Junan","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiating","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7611-2934","authenticated-orcid":false,"given":"Lun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangfang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"8279_CR1","doi-asserted-by":"publisher","first-page":"e0058123","DOI":"10.1128\/msystems.00581-23","volume":"8","author":"Y Tian","year":"2023","unstructured":"Tian Y, Gao R, Wang Y et al (2023) Economic impact of metagenomic next-generation sequencing versus traditional bacterial culture for postoperative central nervous system infections using a decision analysis mode: study protocol for a randomized controlled trial. mSystems 8:e0058123. https:\/\/doi.org\/10.1128\/msystems.00581-23","journal-title":"mSystems"},{"key":"8279_CR2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s13756-018-0305-5","volume":"7","author":"S Pan","year":"2018","unstructured":"Pan S, Huang X, Wang Y et al (2018) Efficacy of intravenous plus intrathecal\/intracerebral ventricle injection of polymyxin B for post-neurosurgical intracranial infections due to MDR\/XDR Acinectobacter baumannii: a retrospective cohort study. 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