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  1. Common Problems and Diagnoses Requiring Neurocritical Care
    1. Increased intracranial pressure (ICP) → requiring close monitoring, hyperosmolar therapy, and/or surgical intervention: related to edema (traumatic brain injury, strokes), lesions with mass effect (intracranial tumor, hematoma, or abscess), hydrocephalus (mass or blood obstructing ventricles, disturbances in cerebrospinal fluid (CSF) homeostasis), central nervous system (CNS) infections
    2. Traumatic brain injury (TBI) → requiring ICP/multimodal monitoring, normothermia, surgical interventions, and often neuroprognostication. Indications for ICP monitoring in TBI:
      1. Severe TBI (GCS 3-8) and an abnormal computed tomography (CT) scan
      2. Severe TBI with a normal CT scan but presence of two of the following: age >40 years, unilateral or bilateral motor posturing, or systolic blood pressure (SBP) <90 mm Hg
    3. Stroke → large-volume strokes usually involving the middle cerebral artery or posterior fossa and requiring monitoring for the development of malignant cerebral edema and subsequent hyperosmolar therapy and/or surgery. Additionally, patients with stroke may demonstrate dynamic changes in symptoms with blood pressure decreases and require temporary augmentation to allow collateral vessels to form.
    4. Subarachnoid hemorrhage (SAH) → requiring close neurologic and hemodynamic monitoring including for vasospasm and delayed cerebral ischemia
    5. Refractory seizures and status epilepticus → requiring intubation due to poor mental status, in the setting of sedating medications, or burst suppression, hemodynamic and metabolic monitoring
    6. Infections of the CNS (meningitis, encephalitis) → requiring intubation due to poor mental status, ICP monitoring, seizure control, CSF diversion
    7. Neuromuscular disease presenting with respiratory failure (Guillain-Barré syndrome/acute inflammatory demyelinating polyneuropathy [AIDP], myasthenia gravis, amyotrophic lateral sclerosis) → requiring mechanical ventilation, autonomic instability (in AIDP)
    8. Toxidromes: serotonin syndrome, neuroleptic malignant syndrome, severe benzodiazepine or alcohol withdrawal → requiring seizure control, close hemodynamic and cardiac monitoring, thermoregulation, and intubation
    9. Spinal cord injury → requiring close hemodynamic monitoring and management of autonomic dysregulation
    10. Postoperative care of complex neurosurgical patients → requiring close monitoring of neurologic exam and hemodynamics
    11. Cardiac or pulmonary failure in the context of neurologic injury
    12. Impaired arousal with the inability to maintain patent airways or need for mechanical ventilation
  2. General Principles of Neurocritical Care: multimodal neuromonitoring (see Section II), neuroprotection, intracerebral hemodynamics