Chapter 41: Critical Care of Patients With Neurologic Emergencies

The content emphasizes rapid assessment, early intervention, and specialized nursing care to prevent irreversible neurologic damage and promote optimal recovery outcomes. Major conditions covered include acute ischemic and hemorrhagic stroke, where recognition of signs and symptoms within the therapeutic window is essential for thrombolytic intervention or mechanical thrombectomy. The chapter details the pathophysiology of intracranial pressure elevation, cerebral perfusion dynamics, and monitoring techniques including intracranial pressure measurement and cerebral oxygenation assessment. Status epilepticus management receives significant attention as a medical emergency requiring prompt pharmacologic intervention and airway protection. Traumatic brain injury assessment encompasses the Glasgow Coma Scale, computed tomography interpretation, and progressive care strategies based on injury severity. The chapter also covers spinal cord injury emergencies, including initial stabilization, methylprednisolone administration considerations, and prevention of secondary injury progression. Subarachnoid hemorrhage, epidural and subdural hematomas, and other acute intracranial pathologies are examined with emphasis on clinical presentation, diagnostic imaging correlation, and time-sensitive interventions. Throughout the chapter, nursing responsibilities focus on continuous neurologic assessment using standardized tools, management of altered consciousness and increased intracranial pressure, seizure precautions, maintenance of respiratory and cardiovascular stability, prevention of complications such as aspiration and deep vein thrombosis, and family communication during critical events. The integration of collaborative care with neurosurgery, neurology, and critical care teams ensures comprehensive management of these complex emergencies requiring specialized knowledge and vigilant monitoring.