Table of ContentsView AllTable of ContentsConditions TreatedWhat the Neuro ICU ProvidesHistoryWho Works in a Neuro ICUOutcomes

Table of ContentsView All

View All

Table of Contents

Conditions Treated

What the Neuro ICU Provides

History

Who Works in a Neuro ICU

Outcomes

A neuro ICU is an intensive care unit devoted to the care of patients with immediately life-threatening neurological problems. It was established in response to the need for more specialized knowledge in the growing techniques for recognizing and addressing neurological disorders.

This article will explore the reasons a patient might need the neuro ICU and the history of neuro ICU departments. It also covers the specialists one might encounter at a neuro ICU and the specialized skills that they have.

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Close up of equipment in the ICU

Problems Managed in a Neuro ICU

In general, a patient may be admitted to a neuro ICU for the following conditions:

Because of the serious nature of the reasons people are admitted to a neuro ICU, the length of the stay can be potentially long. In one study, patients on a ventilator remained in the neuro ICU for around 16 days. Patients who did not need a ventilator stayed for around three to four days.

Neurointensive care covers more than just a wide range of diseases. It also requires specialized knowledge about specific mechanics of the body, such as how the brain controls its blood flow andintracranial pressure,

It also requires knowledge of neurological tools such as:

Specialized Examination Techniques

Patients with damage to their nervous systems differ significantly from those with damage to other vital areas of the body. Nervous system diseases can affect a patient’s ability to move and communicate.Therefore, neuro ICU staff must be trained in special examination techniques to gather critical information.

Individualized Care

The personal nature of severe neurological illnesses also cannot be understated. Neurological illness can change how a person perceives loved ones and can essentially make them behave like a completely different person.Even worse, some neurological illnesses can seem to rob us of what makes us who we are. The emotional fragility these changes can provoke in friends and family members requires special attention. This becomes even more important when discussing topics such asbrain death.

The History of the Neuro ICU

In some ways, the very first intensive care units were neuro ICUs. The need for ICUs was firmly established in the 1950s because of the paralyzing effect of the polio virus.As paralyzed people with polio lost their ability to breathe, they were placed on the then-new technology of mechanical ventilation.

For decades, intensive care units took care of every type of life-threatening illness, especially those that led to a need for mechanical ventilation. However, the need for more specialized care became increasingly evident as our understanding of medicine became more complex. In 1977, the first large general academic neuro ICU in North America was started at Massachusetts General Hospital. From there, they became increasingly popular across the nation and the world.

Most neuro ICUs are found in large academic hospitals that receive a steady stream of patients. Smaller hospitals may not have enough patients to justify constructing a neuro ICU. They will either care for the patient in a general ICU or transfer the patient to a different hospital.

Neuro ICUs are very multi-disciplinary.

The benefit of having so many specialists is that a wide range of expertise is brought into each patient’s care. The downside is that unless very close attention is paid to who is speaking, it is easy for friends and families to get confused about who they’re talking to and why.

Compared with general intensive care units, neuro ICUs have been associated with lower mortality and shorter hospital stays for disorders like stroke, cerebral hemorrhage, and traumatic brain injury.Intensive care units, in general, can be frightening and confusing, but with close attention to good communication, a neuro ICU can be a lifesaver.

Outcomes in the Neuro ICU

Regardless of the reason someone is admitted to the neuro ICU, those receiving care in a neuro ICU setting are very sick. The overall mortality rate for people in a neuro ICU versus a generalized medical ICU is improved. According to one meta-analysis, those in a neuro ICU have a 17% lower risk of mortality than those in a general ICU.

Factors that increase the likelihood of mortality among those receiving neuro ICU care are older age, additional injuries, and lower Glasgow coma score (GCS) upon admission.

Summary

Specialized neuro ICUs are imperative for treating complex neurological conditions such as stroke, traumatic brain injury, bleeding in the brain, spinal trauma, and a host of other conditions. The healthcare providers in neuro ICU departments have specialized knowledge and skills. For those who require this specialized care, being in a neuro ICU instead of a general ICU can improve outcomes.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Backhaus R, Aigner F, Schlachetzki F et al.Inventory of a Neurological Intensive Care Unit: Who Is Treated and How Long?Neurol Res Int. 2015;2015:1-7. doi:10.1155/2015/696038Backhaus R, Aigner F, Schlachetzki F, et al.Inventory of a neurological intensive care unit: who is treated and how long?Neurol Res Int. 2015;2015:696038. doi:10.1155/2015/696038King ML, Manzel K, Bruss J, Tranel D.Neural correlates of improvements in personality and behavior following a neurological event.Neuropsychologia. 2020;145:106579. doi:10.1016/j.neuropsychologia.2017.11.023Kollmar R, De Georgia M.Milestones in the history of neurocritical care.Neurol Res Pract. 2023;5:43. doi:10.1016/B978-0-444-63600-3.00001-5Giugni A, Gamberini L, Carrara G, et al.Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury.Scand J Trauma Resusc Emerg Med. 2021;29:158. doi:10.1186/s13049-021-00959-2Kramer A, Couillard P.Neurocritical Care: A Growing International Collaborative.Neurocrit Care. 2019;32(1):80-83. doi:10.1007/s12028-019-00858-6Pham X, Ray J, Neto AS, et al.Association of neurocritical care services with mortality and functional outcomes for adults with brain injury.JAMA Neurol. 2022;79(10):1049-1058. doi:10.1001/jamaneurol.2022.2456Réa-Neto Á, Bernardelli RS, de Oliveira MC, et al.Epidemiology and disease burden of patients requiring neurocritical care: a Brazilian multicentre cohort study.Sci Rep. 2023;13:18595. doi:10.1038/s41598-023-44261-wAdditional ReadingAllan H. Ropper, Daryl R. Gress, Michael .N Diringer, Deborah M. Green, Stephan A. Mayer, Thomas P. Bleck, Neurological and Neurosurgical Intensive Care, Fourth Edition, Lippicott Williams & Wilkins, 2004Pedro Kurtz, Vincent Fitts, Zeynep Sumer, Hillary Jalon and Joseph Cooke, et al.How Does Care Differ for Neurological Patients Admitted to a Neurocritical Care Unit Versus a General ICU? Neurocritical Care, 2011, Volume 15, Number 3, Pages 477-480

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Backhaus R, Aigner F, Schlachetzki F et al.Inventory of a Neurological Intensive Care Unit: Who Is Treated and How Long?Neurol Res Int. 2015;2015:1-7. doi:10.1155/2015/696038Backhaus R, Aigner F, Schlachetzki F, et al.Inventory of a neurological intensive care unit: who is treated and how long?Neurol Res Int. 2015;2015:696038. doi:10.1155/2015/696038King ML, Manzel K, Bruss J, Tranel D.Neural correlates of improvements in personality and behavior following a neurological event.Neuropsychologia. 2020;145:106579. doi:10.1016/j.neuropsychologia.2017.11.023Kollmar R, De Georgia M.Milestones in the history of neurocritical care.Neurol Res Pract. 2023;5:43. doi:10.1016/B978-0-444-63600-3.00001-5Giugni A, Gamberini L, Carrara G, et al.Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury.Scand J Trauma Resusc Emerg Med. 2021;29:158. doi:10.1186/s13049-021-00959-2Kramer A, Couillard P.Neurocritical Care: A Growing International Collaborative.Neurocrit Care. 2019;32(1):80-83. doi:10.1007/s12028-019-00858-6Pham X, Ray J, Neto AS, et al.Association of neurocritical care services with mortality and functional outcomes for adults with brain injury.JAMA Neurol. 2022;79(10):1049-1058. doi:10.1001/jamaneurol.2022.2456Réa-Neto Á, Bernardelli RS, de Oliveira MC, et al.Epidemiology and disease burden of patients requiring neurocritical care: a Brazilian multicentre cohort study.Sci Rep. 2023;13:18595. doi:10.1038/s41598-023-44261-wAdditional ReadingAllan H. Ropper, Daryl R. Gress, Michael .N Diringer, Deborah M. Green, Stephan A. Mayer, Thomas P. Bleck, Neurological and Neurosurgical Intensive Care, Fourth Edition, Lippicott Williams & Wilkins, 2004Pedro Kurtz, Vincent Fitts, Zeynep Sumer, Hillary Jalon and Joseph Cooke, et al.How Does Care Differ for Neurological Patients Admitted to a Neurocritical Care Unit Versus a General ICU? Neurocritical Care, 2011, Volume 15, Number 3, Pages 477-480

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Backhaus R, Aigner F, Schlachetzki F et al.Inventory of a Neurological Intensive Care Unit: Who Is Treated and How Long?Neurol Res Int. 2015;2015:1-7. doi:10.1155/2015/696038Backhaus R, Aigner F, Schlachetzki F, et al.Inventory of a neurological intensive care unit: who is treated and how long?Neurol Res Int. 2015;2015:696038. doi:10.1155/2015/696038King ML, Manzel K, Bruss J, Tranel D.Neural correlates of improvements in personality and behavior following a neurological event.Neuropsychologia. 2020;145:106579. doi:10.1016/j.neuropsychologia.2017.11.023Kollmar R, De Georgia M.Milestones in the history of neurocritical care.Neurol Res Pract. 2023;5:43. doi:10.1016/B978-0-444-63600-3.00001-5Giugni A, Gamberini L, Carrara G, et al.Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury.Scand J Trauma Resusc Emerg Med. 2021;29:158. doi:10.1186/s13049-021-00959-2Kramer A, Couillard P.Neurocritical Care: A Growing International Collaborative.Neurocrit Care. 2019;32(1):80-83. doi:10.1007/s12028-019-00858-6Pham X, Ray J, Neto AS, et al.Association of neurocritical care services with mortality and functional outcomes for adults with brain injury.JAMA Neurol. 2022;79(10):1049-1058. doi:10.1001/jamaneurol.2022.2456Réa-Neto Á, Bernardelli RS, de Oliveira MC, et al.Epidemiology and disease burden of patients requiring neurocritical care: a Brazilian multicentre cohort study.Sci Rep. 2023;13:18595. doi:10.1038/s41598-023-44261-w

Backhaus R, Aigner F, Schlachetzki F et al.Inventory of a Neurological Intensive Care Unit: Who Is Treated and How Long?Neurol Res Int. 2015;2015:1-7. doi:10.1155/2015/696038

Backhaus R, Aigner F, Schlachetzki F, et al.Inventory of a neurological intensive care unit: who is treated and how long?Neurol Res Int. 2015;2015:696038. doi:10.1155/2015/696038

King ML, Manzel K, Bruss J, Tranel D.Neural correlates of improvements in personality and behavior following a neurological event.Neuropsychologia. 2020;145:106579. doi:10.1016/j.neuropsychologia.2017.11.023

Kollmar R, De Georgia M.Milestones in the history of neurocritical care.Neurol Res Pract. 2023;5:43. doi:10.1016/B978-0-444-63600-3.00001-5

Giugni A, Gamberini L, Carrara G, et al.Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury.Scand J Trauma Resusc Emerg Med. 2021;29:158. doi:10.1186/s13049-021-00959-2

Kramer A, Couillard P.Neurocritical Care: A Growing International Collaborative.Neurocrit Care. 2019;32(1):80-83. doi:10.1007/s12028-019-00858-6

Pham X, Ray J, Neto AS, et al.Association of neurocritical care services with mortality and functional outcomes for adults with brain injury.JAMA Neurol. 2022;79(10):1049-1058. doi:10.1001/jamaneurol.2022.2456

Réa-Neto Á, Bernardelli RS, de Oliveira MC, et al.Epidemiology and disease burden of patients requiring neurocritical care: a Brazilian multicentre cohort study.Sci Rep. 2023;13:18595. doi:10.1038/s41598-023-44261-w

Allan H. Ropper, Daryl R. Gress, Michael .N Diringer, Deborah M. Green, Stephan A. Mayer, Thomas P. Bleck, Neurological and Neurosurgical Intensive Care, Fourth Edition, Lippicott Williams & Wilkins, 2004Pedro Kurtz, Vincent Fitts, Zeynep Sumer, Hillary Jalon and Joseph Cooke, et al.How Does Care Differ for Neurological Patients Admitted to a Neurocritical Care Unit Versus a General ICU? Neurocritical Care, 2011, Volume 15, Number 3, Pages 477-480

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