Foreword

Three converging realities provide the raisons d’etre for this new edition of The NeuroICU Book. First, management of neurological and neurosurgical patients is becoming increasingly complex and fluid as diagnostic and therapeutic options increase. There are few “standards of care” that have not substantially changed over the past few years. Second, as our population increases, engages in risky behavior, and ages, the burden of trauma and neurological disease threatens to overwhelm our hospitals. The number of physicians and other staff who need training to care for these patients is truly exploding. Finally, evidence-based protocol-driven care improves quality metrics, value and patient centered outcomes. Every hospital and healthcare system now accepts and is adapting to this new reality of medical practice. Nowhere are these themes more evident than in the NeuroICU, hence the need for a comprehensive, authoritative, and easily negotiated reference for medical staff managing patients in this environment.

This second edition of The NeuroICU Book builds on the huge success of the first edition published in 2012. The interactive, case-driven format of the first edition is retained, with practical recommendations that consider the myriad possible responses of patients to our interventions. Little is predictable in the NeuroICU, and this book prepares the reader for the unexpected. The second edition follows the general organization of the first, with expanded coverage of encephalopathy, spine trauma, pediatric neurosurgery, and newer cardiovascular interventions such as extracorporeal membrane oxygenation.

Dr Lee has assembled an all-star lineup of authors; they are interdisciplinary leaders in their fields. Rarely will one find a more comprehensive and authoritative compilation within the front and back covers of any textbook. The chapters are all edited for consistent style, so that each topic is not only covered with the same degree of expertise and depth, but once familiar with the approach, the reader can easily find within each chapter the coverage they are seeking.

Finally, while this text will be most useful to those who work full-time in the NeuroICU, it is a welcome addition to the bookshelf of any clinician taking care of hospitalized neurological and neurosurgical patients. The new reality of neurological care is that a large percentage of hospitalized patients will spend some time in the NeuroICU, or require ICU-level care while in the ED, endovascular suite, or other non-ICU setting. Hence patients are frequently co-managed by clinicians who will care for the patient before they transition into, or after they move out of, the NeuroICU. As a vascular neurologist, I frequently dive into the “non-stroke” chapters to help me understand what Dr Lee and his staff are doing or would be doing with my patients!