The focus of acute treatment of intracerebral hemorrhage (ICH) includes acute blood pressure management, prevention of secondary hematoma expansion through anticoagulation reversal, and neurosurgical interventions for select patients. Recent evidence points to ultra-early acute ICH bundles, implementing multiple therapies in parallel, as the most impactful therapy in reducing morbidity and mortality. It is time for widespread implementation of formalized care bundles in ICH, including specific metrics for time to treatment and criteria for neurosurgical therapy. No longer just "Code Stroke," it is time for "Code ICH.".

Acute care for ischemic stroke has dramatically evolved over the last years. Cerebral reperfusion is possible up to 24 h after symptoms onset. Advanced brain imaging allows identifying salvageable ischemic brain tissue, and the development of newer endovascular devices permits access to distal vessels. Monitoring for neurologic deterioration, diagnosis of stroke etiology, and secondary prevention treatments are important after initial treatment. This article reviews the recent advancements in the critical care of acute ischemic stroke.

In patients with status epilepticus (SE), the underlying biologic background represents the main prognostic variable. A swift application of a treatment protocol is recommended, including adequate doses of a benzodiazepine followed by an intravenous anti-seizure medicine. If refractory SE arises, general anesthetics should be used in generalized convulsive and non-convulsive SE in coma, while further non-sedating anti-seizure medications attempts are warranted in patients with focal forms. Ketogenic diet and/or ketamine in patients with super-refractory SE, and immunologic treatments for those with new-onset refractory SE/febrile-induced refractory epilepsy syndrome should be considered early. Pharmacologic treatment of SE after cardiac arrest should be oriented by the results of multimodal prognostication.

Posterior reversible encephalopathy syndrome consists of acute to subacute symptoms which include seizures, encephalopathy, headaches, visual hallucinations or visual loss, and focal neurologic deficits in the setting of vasogenic brain edema. Both the clinical and radiographic findings are reversible in most, leading to a favorable neurologic prognosis. Less commonly, patients may have residual neurologic sequelae, often in cases with associated structural injury such as intracranial hemorrhage or stroke. A minority of patients develop a severe form, "malignant PRES" which can be fatal and may require intensive care unit care with aggressive therapies such as intubation, hyperosmolar therapy, ventriculostomy placement, or decompressive surgery.

Electroencephalography (EEG) has been used to assess brain electrical activity for over a century. More recently, technological advancements allowed EEG to be a widely available and powerful tool in the intensive care unit (ICU), where patients at risk for cerebral dysfunction and brain injury can be monitored in a continuous, real-time manner. In the last 2 decades, several organizations established guidelines for continuous EEG monitoring in the ICU, defining critical care EEG terminology and technical standards for technicians, machines, and electroencephalographers. This article provides an overview of the current role of continuous EEG monitoring in the ICU.

Expansion of artificial intelligence (AI) in the field of medicine is changing the paradigm of clinical practice at a rapid pace. Incorporation of AI in medicine offers new tools as well as challenges, and physicians and learners need to adapt to assimilate AI into practice and education. AI can expedite early diagnosis and intervention with real-time multimodal monitoring. AI assistants can decrease the clerical burden of heath care improving the productivity of work force while mitigating burnout. There are still no regulatory parameters for use of AI and regulatory framework is needed for the implementation of AI systems in medicine to ensure transparency, accountability, and equitable access.

Patients with moderate traumatic brain injury (TBI) are at high risk for developing intracerebral complications and in particular neuroworsening (NW). NW can be unpredictable and may be an important risk factor for poor neurologic outcome and for increased mortality. NW is often a medical and surgical emergency, and it is, therefore, fundamental to identify patients at risk early because they require strict neuromonitoring and repeated neuroimaging. So far, there is no standardized and validated definition of NW. In this review, we aim to discuss the definition, risk factors, and management of patients with moderate TBI at high risk of NW.

This review provides a comprehensive overview of the contemporary management strategies for acute and chronic subdural hematomas, delineating their distinct clinical characteristics, risk factors, etiologies, and treatment paradigms. Through a synthesis of current evidence and emerging trends, this review explores established therapeutic strategies alongside innovative modalities under active investigation. This article equips clinicians with a nuanced understanding of optimal care pathways for both acute and chronic subdural hematomas, thus facilitating improved patient outcomes.

This study critically reviews prognostication, brings into focus its "refinement" over the decades, and provides a template for clinicians who must judge the functioning of patients who awaken. This includes the use of diagnostic tests, including neuroimaging, electrophysiology, and laboratory testing that may aid in evaluating neurologic recovery. The article reviews recent guidelines and provides advice informed by many years of clinical experience.

Delirium is not a harmless transient event during ICU hospitalization; rather, it is a severe complication of critical illness associated with increased mortality, morbidity, and persistent disability. Despite being recognized for decades, it remains underdiagnosed. Employing validated tools for detection helps reduce missed cases. Early detection facilitates prompt management. Sedatives, opioids, and antipsychotics should be avoided whenever possible. Optimizing environmental triggers, minimizing iatrogenicity, and treating underlying critical illness constitute the basis of the currently recommended approach to diminish the burden of delirium in ICU patients.

Subarachnnoid hemorrhage (SAH) present in a spectrum of clinical severity, from alert with a headache to comatose. High-grade SAH has higher mortality and risk for severe complications including acute respiratory distress syndrome (ARDS) and delayed cerebral ischemia (DCI). Existing treatment approaches for ARDS in SAH require special consideration because of potential impact on intracranial pressure and cerebral perfusion. DCI is a major cause of SAH morbidity and is often discordant with angiographic vasospasm. Current treatment approaches for DCI and vasospasm require further investigation to determine efficacy and risk/benefit. Nimodipine remains the only therapeutic that is proven to improve SAH outcome.

Cognitive dysfunction is common in cancers and their treatments. Factors that can contribute to cognitive dysfunction include direct and indirect effects of cancer, surgery, radiation, systemic therapy, as well as comorbidities, fatigue, and mood disturbance. Using objective, validated measures, a neuropsychological evaluation can provide information regarding patterns of cognitive function. Emphasis of cognitive domains assessed may vary depending on disease and treatment history. Cognitive interventions can minimize the effects of cancer-related cognitive dysfunction on daily life.

Advances in trauma care have allowed persons with traumatic brain injury to survive at increasingly greater rates. However, they commonly go on to experience complex symptoms including changes in cognitive, emotional, and behavioral functioning that together limit functioning and quality of life. Clinical neuropsychology is uniquely skilled to work together with other rehabilitation professionals, using a patient centered approach, evidence-based treatments, and increasingly using emerging technology while adhering to ethical principles of respect, beneficence, and justice. Doing so will most effectively manage these changes, leading to the best possible quality of life and maximum improvement in functioning.

Individuals with neurologic illness/injury often experience changes in their daily functioning. Clinical providers caring for these individuals are frequently called upon for input as patients and their families navigate challenging decisions to ensure safety. This article reviews 3 areas in which recommendations from clinicians are often requested: medical decision-making, home safety, and driving. Strategies for making recommendations in these areas is offered including discussion of how neuropsychology evaluations can provide useful information to aid in making recommendations.

In this review article, the authors describe the invaluable role that neuropsychology plays in neurosurgical care for a broad range of pathologies. As our understanding of cognitive and behavioral implications of diseases and surgical management of the brain has deepened, so has the need to preserve the quality of life for patients undergoing surgery to optimize well-being and overall survival. This article recounts the history of neuropsychology, details tools and techniques used by neuropsychologists including the neuropsychological assessment, fMRI, tractography, and awake surgery, and discusses the practical applications of neuropsychological evaluation in tumor surgery, epilepsy, deep brain modulation, and beyond.

Research regarding the delivery of neuropsychological feedback (NF) has grown in recent years to include specific models and strategies for working with patients with diverse medical conditions across the lifespan, and is now considered a core competency for neuropsychologists. NF is an individualized therapeutic intervention designed to maximize the patient's understanding of assessment results and catalyze follow through with treatment recommendations. This article summarizes research on NF and its strategic goals, as well as the potential impact/outcomes of these therapeutic interventions. One specific model (Therapeutic Assessment) is described in detail and illustrated through a clinical vignette.

Cognitive rehabilitation following traumatic brain injury (TBI) involves a targeted, individualized approach to address deficits in attention, memory, executive functions, and/or other cognitive domains. This overview highlights the importance of thorough assessment to inform cognitive rehabilitation, a multidimensional approach, and current best practices in intervention strategies. It provides exemplar compensatory strategies for each cognitive domain. In addition to broad clinical practice guidelines, it also addresses unique considerations that may be warranted in some subgroups with TBI. Finally, outcome measurement is summarized.

Mild Cognitive Impairment (MCI) and dementia are becoming more common with an aging population, and the numbers are expected to rise. These conditions can have a significant impact on patients, family, and health care systems. Lifestyle changes including physical activity, nutrition, quality sleep, socialization, cognitive activity and mental stimulation, routine medical care, and mental health care have the potential to prevent cognitive and functional decline and optimize daily living in all individuals, including those with MCI and early neurodegenerative disease. Brain Boosters is an important group intervention used to provide psychoeducation on lifestyle factors and strategies that can improve brain health, cognition, and functioning.

Cognition is influenced by a host of factors, including the patient's medical, psychiatric, and developmental history; sociocultural and demographic factors; modifiable behavioral factors; and structural and social determinants of health. Neuropsychological approaches include interpreting test data in the context of these factors to classify impairment and derive a cognitive diagnosis accurately. Failure to integrate an individual's sociodemographic, sociocultural, and developmental background can result in diagnostic errors, which have critical clinical implications for patient care.