Neurocritical care reference
The physiology behind the protocol
Protocols tell you what to do. This site is about why — the anatomy and physiology that the numbers on the monitor are standing in for, and where the published guidance is firmer or softer than it first appears.
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Anatomy & Physiology
Intracranial compliance, the Monro–Kellie doctrine, autoregulation and cerebral blood flow — the mechanisms the bedside numbers describe.
Guidelines
Summaries of the major published recommendations, with the strength of evidence behind each one stated plainly.
Blog
Short write-ups on recurring bedside questions, and the reasoning that sits underneath the usual answers.
Recent posts
Reading an ICP waveform before you read the number
The three peaks of a normal ICP trace carry information about compliance that the mean value hides completely.
Sedation holds in the injured brain: the exception, not the rule
Daily interruption is well supported in general critical care. The neuro population is where that evidence stops being straightforward.
Why we chase cerebral perfusion pressure, not blood pressure
A mean arterial pressure that looks reassuring on the monitor can still be starving an injured brain. Here's the arithmetic behind that.
A note on scope. Everything here is written for education and revision. It is not medical advice, it will not be as current as the source documents it summarises, and it never overrides your own unit's protocols or your clinical judgement.