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GCS · TBI · brain death

Neurocritical Care

Neurologic exam structure, traumatic brain injury priorities, spinal cord concerns, and brain-death workflow awareness.

Attribution: SurgCritCare handbook
Updated: 5/29/2026

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Neurocritical Care Topics

At a Glance

Review neuro exam structure, TBI priorities, spinal cord concerns, and brain-death workflow basics.

Neurologic monitoringTrend exam, GCS components, sedation confounders, pupillary findings, and imaging changes.

Document GCS components, not only total.
Separate sedation effect from neurologic change.
Escalate new focal deficits.

Severe TBI prioritiesAvoid secondary injury by protecting oxygenation, perfusion, temperature, glucose, and sodium targets as directed locally.

Prevent hypotension and hypoxemia.
Coordinate neurosurgery and ICU plans.
Use local protocol targets when available.

Neurocritical Care Topics

Neurologic exam structure, TBI priorities, spinal cord concerns, and brain-death workflow awareness.

Acute TBI Management — Vella 2017Acute traumatic brain injury review covering prevention of secondary injury, cerebral perfusion goals, intracranial pressure management, mass lesions, VTE prophylaxis, seizures, and nutrition.Open page Brain Death DeterminationEducational overview of brain death clinical criteria, prerequisites, examination, apnea testing, and ancillary testing. Based on AAN guidelines. Pending institutional review.Open page Brain Death Determination — LectureDetermination of Brain Death A Little History... • Advanced cardiopulmonary support created the awareness of neurologic death • 1959 - Mollaret and Goulon published “le coma dépassé” o Foundation for understanding that...Open page Acute Cervical Spinal Cord Injury — Diagnosis & ManagementPatients with acute cervical spinal cord injury present complex clinical challenges. These injuries may result in motor and sensory deficits and also in cardiovascular and respiratory perturbations. Increased attention...Open page Encephalopathies in the Surgical ICUOverview of encephalopathies in surgical ICU patients: etiology, clinical presentation, and the two overarching treatment goals of supportive care and targeted therapy.Open page ICU Delirium — Recognition, Prevention, and ManagementDelirium in the ICU: types (hypoactive, hyperactive, mixed), diagnosis using CAM-ICU and RASS, ABCDEF bundle, consequences, and treatment principles.Open page Neuro Assessments & Glasgow Coma Scale (GCS)Glasgow Coma Scale (GCS) description, component scoring, and application in trauma and surgical critical care.Open page Severe Traumatic Brain Injury (TBI)Guideline-supported educational overview of severe TBI management including initial stabilization, ICP management, and neuroprotective care.Open page Severe TBI Management — Lecture NotesSevere TBI Management Mechanisms of TBI • Focal = contact injury ocausing laceration, contusion, intracranial hemorrhage • Diffuse = acceleration/deceleration injury, anoxic oleading to brain swelling, diffuse axonal...Open page Spinal Cord InjurySpinal cord injury overview including secondary injury prevention, MAP goals, ASIA classification, neurogenic vs. spinal shock, autonomic dysreflexia, and SICU complications.Open page ACS TQIP Spine Injury GuidelinesACS TQIP spine injury guidance covering initial evaluation, spinal motion restriction, imaging, classification, spinal cord injury care, neurogenic shock, and VTE prophylaxis.Open page ACS TQIP Severe TBI GuidelinesACS TQIP traumatic brain injury guidance covering GCS assessment, triage and transport, treatment goals, ICP management, operative considerations, nutrition, tracheostomy, VTE prophylaxis, and special populations.Open page

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Neurocritical Care Topics

Educational use only. Confirm clinical decisions with current institutional policy, source documents, and attending direction.