Neurocritical Care in 2024: Where are We Headed?

World Neurosurg. 2024 Dec 17:193:330-337. doi: 10.1016/j.wneu.2024.09.118. Online ahead of print.

Abstract

Providing specialized care to critically ill neurology patients has improved outcomes for patients with neurological emergencies; however, there are still some gaps in neurocritical care (NCC) that offer opportunities for improvement. Among these gaps, improving education of the multidisciplinary NCC team, targeting individualized treatments for neurologically critically ill patients, and reducing disparities for undeserved patients as well as disadvantaged areas are priorities to advance the field. This review focuses on the current challenges neurointensivists face, including difficulties in neuroprognostication, ethical challenges in end-of-life care, and neuropalliative care. Challenges also involve providing specific NCC education for the multidisciplinary NCC team, as well as advancing research to provide treatments for critically ill neurological patients. Finally, the authors describe future directions that can take NCC to the next level.

Keywords: Disparity; Education; ICU palliative care; Neuro-ICU; Neuromonitoring.