Neurosurgical ICU (Neuro ICU) Rotation

The Neurosurgical ICU (Neuro ICU) cares for critically ill patients with neurologic and neurosurgical conditions. While on this rotation, fellows gain experience in the postoperative management of patients, such as after patients undergo surgeries including cerebral aneurysm clippings, spinal cord surgery, tumor resections and epilepsy surgery.  Key skills to focus on during this rotation include:

  • indications, rationale and technique of Intracranial Pressure monitoring in the case of acute brain injury
  • stepwise management protocol for intracranial hypertension
  • fundamental troubleshooting of an external ventricular drain
  • evidence-based Emergency Department and ICU management of aneurysmal subarachnoid hemorrhage
  • evidence-based management of blood pressure in the case of intracranial hemorrhage and acute ischemic stroke
  • an algorithm for management of status epilepticus

Fellows work closely with the ICU Attending to direct all critical care management. To be an integral member of this ICU team, fellows must be present Monday through Friday. Fellows therefore have weekends and holidays off during this rotation. Other expectations during this rotation include:

  • participation in neurosurgery rounds and ICU rounds, where fellows are responsible for all ICU issues that arise until sign-out with the ICU faculty
  • assistance with bedside procedures during working hours in the ICU and supervision of interns and residents performing procedures
  • instruction of interns and residents in general ICU management strategies
  • in addition to didactic activities of the core program, fellows must also be present for all NeuroICU lectures