Neurocritical Care

Neurocritical care is a specialized field of medicine dedicated to the comprehensive care and management of patients with critical neurological conditions. These conditions often involve severe brain injury, stroke, neurosurgical procedures, and other life-threatening neurological emergencies. Neurocritical care units, staffed by highly trained healthcare professionals, provide intensive monitoring, specialized treatments, and advanced interventions tailored to the unique needs of these patients. 

Common Diseases Treated By The Department

  • Stroke: Including ischemic strokes (due to blocked blood vessels) and hemorrhagic strokes (due to bleeding in the brain).
  • Traumatic Brain Injury (TBI): Serious head injuries resulting from accidents, falls, or violence, which may lead to brain swelling, hemorrhage, and other complications.
  • Subarachnoid Hemorrhage: Bleeding in the space between the brain and the surrounding membrane, often due to a ruptured aneurysm.
  • Intracerebral Hemorrhage: Bleeding directly into the brain tissue, which can cause brain damage.
  • Status Epilepticus: A condition where the patient experiences prolonged seizures or a series of seizures without regaining consciousness between them.
  • Spinal Cord Injuries: Severe injuries to the spinal cord that may result in paralysis, loss of sensation, and other serious complications.
  • Brain Tumors: Managing complications and postoperative care for patients who have undergone surgery for brain tumors.
  • Meningitis and Encephalitis: Severe infections of the brain and spinal cord, requiring intensive care and close monitoring.
  • Acute Neuromuscular Disorders: Such as Guillain-Barré syndrome or myasthenic crisis, which can affect breathing and other vital functions.
  • Postoperative Care: For patients who have undergone complex neurosurgical procedures, requiring careful postoperative monitoring and management.
  • Cerebral Edema: Swelling of the brain, which can occur due to various conditions like traumatic brain injury, stroke, or infection.
  • Ventriculostomy Management: For conditions requiring the drainage of cerebrospinal fluid to relieve pressure in the brain, such as hydrocephalus.

Key Procedures

In a Neuro Critical Care department, also known as a Neurological Intensive Care Unit (Neuro ICU), various specialized procedures are performed to manage and treat critically ill patients with acute neurological conditions. Common procedures include:

  • Intracranial Pressure (ICP) Monitoring: Insertion of a device to measure the pressure inside the skull, crucial for patients with conditions like traumatic brain injury, stroke, or brain hemorrhage.
  • Ventilatory Support: Mechanical ventilation for patients who are unable to breathe adequately on their own, often required in cases of severe brain injury or neuromuscular disorders.
  • External Ventricular Drain (EVD) Placement: Insertion of a drain to remove excess cerebrospinal fluid in conditions like hydrocephalus or to relieve elevated intracranial pressure.
  • Thrombectomy: A procedure to remove a clot from a blood vessel in the brain in cases of acute ischemic stroke.
  • Lumbar Puncture: To collect cerebrospinal fluid for diagnostic purposes or to relieve pressure in conditions like meningitis.
  • Tracheostomy: Creating an opening in the neck to place a tube into the windpipe to provide an airway and remove secretions from the lungs.
  • Continuous EEG Monitoring: Used to monitor brain activity, particularly in patients with seizures or unexplained coma.
  • Targeted Temperature Management (Therapeutic Hypothermia): Cooling the body to protect the brain after events like cardiac arrest or severe brain injury.
  • Vasopressor Support: Administration of medication to maintain adequate blood pressure in critically ill neurological patients.
  • Cerebral Angiography: An imaging test to visualize blood vessels in and around the brain, often used in diagnosing and treating conditions like aneurysms or vascular malformations.
  • Decompressive Craniectomy: Surgical removal of part of the skull to relieve pressure in the brain due to swelling.
  • Sedation and Analgesia Management: Critical for managing discomfort and agitation, and to facilitate other procedures in critically ill patients.

Advantages Of The Department

  • Specialized Care: The department provides focused care for critical neurological conditions, ensuring patients receive the most appropriate and advanced treatments.
  • Expertise of Staff: Neuro ICU staff, including neurologists, neurosurgeons, critical care specialists, nurses, and therapists, are specially trained in managing complex neurological conditions.
  • Advanced Monitoring and Technology: The department is equipped with state-of-the-art technology for continuous monitoring of neurological status, intracranial pressure, and other vital parameters, crucial for timely interventions.
  • Multidisciplinary Approach: The Neuro ICU integrates care across specialties, including neurology, neurosurgery, radiology, and physical therapy, offering comprehensive patient management.
  • Rapid Response and Intervention: Immediate access to advanced interventions like thrombectomy for stroke, decompressive surgeries, and advanced life support can be life-saving and reduce the risk of long-term disability.
  • Improved Outcomes: Specialized care in Neuro ICUs has been shown to improve outcomes in severe neurological conditions, reducing mortality and improving the quality of life post-recovery.
  • Rehabilitation Services: Early and integrated rehabilitation services, crucial for neurological recovery, are often initiated in the Neuro ICU.

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Meet Our Doctors

Dr. Rajul Aggarwal

Unit Head & Sr. Consultant

Neurology, Stroke, Neurocritical Care, Institute of Neurosciences

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Dr. Rajul Aggarwal

Unit Head & Sr. Consultant

Dr. Sandhya Koche

Sr. Consultant

Neurology, Stroke, Neurocritical Care, Institute of Neurosciences

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Dr. Sandhya Koche

Sr. Consultant

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