Being responsible for a neurological intensive care unit without knowledge and/or experience should provoke anxiety. This handbook is intended to improve your judgment from the experience of others. Each chapter has been authored by an expert in the field. We do not imply that there is no other way to manage neurologically critically ill patients, but only that this is one expert way to do so. Others may argue that there are better ways to manage specific problems, and, on occasion, it will be correct. However, the authors believe this book will not disappoint the clinicians in search of new knowledge, a refresher, and options.

As the first vital sign, temperature occupies a prominent place in the initial assessment of a patient and is of particular significance in an acutely ill patient in the neurocritical care unit. Its interpretation, measurement, and clinical significance can be confounded by the disruption of the normal thermoregulatory mechanisms of the central nervous system, as well as various pharmacotherapies. This chapter aims to provide the reader with an overview of the clinical approach to fever in the neurocritical care unit. This will encompass a discussion of the common causes of fever, including serotonin syndrome, neuroleptic malignant syndrome, malignant hyperthermia, and paroxysmal sympathetic hyperreactivity. Finally, we describe how temperature can be leveraged as an evidence-based therapeutic tool to help improve neurologic outcomes after cardiac arrest.