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Review Article
- Neurosurgery
- Interdisciplinary collaboration in neurocritical care management
- Hyunchul Jung, Seung Bin Kim, Seungjoo Lee, Moinay Kim
- Acute Crit Care. 2026;41(2):226-236. Published online January 29, 2026
- DOI: https://doi.org/10.4266/acc.003275
- 2,748 View
- 112 Download
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Abstract
PDF - The complexity of neurocritical care requires a shift from traditional, discipline-specific practice toward a collaborative, interdisciplinary model. This review explores the conceptual and practical framework of interdisciplinary collaboration in neuro-intensive care units, examining the roles of key specialists including neurosurgeons, neurologists, intensivists, pharmacists, nutritionists, and rehabilitation experts. We discuss the benefits of coordinated care in improving patient-centered outcomes, reducing morbidity and mortality, and enhancing intensive care unit efficiency. Emerging evidence supports the integration of neurointensivists, structured communication tools, and team-based decision-making as essential components of modern critical care delivery. This article provides a comprehensive review of current strategies and proposes directions for advancing interdisciplinary practice in neurocritical care settings.
Original Articles
- Neurosurgery
- Role of serum magnesium in post-aneurysmal subarachnoid hemorrhagic hydrocephalus
- Moinay Kim, Hyunchul Jung, Seung Bin Kim, Jun Ha Hwang, Hanwool Jeon, Yeongu Chung, Youngbo Shim, Jae Hyun Kim, Joonho Byun, Aiden Cousins, Wonhyoung Park, Jung Cheol Park, Jae Sung Ahn, Seungjoo Lee
- Acute Crit Care. 2025;40(4):582-593. Published online November 28, 2025
- DOI: https://doi.org/10.4266/acc.003550
- 1,567 View
- 86 Download
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Abstract
PDF
- Background
Post-hemorrhagic hydrocephalus (PHH) is a frequent complication of aneurysmal subarachnoid hemorrhage (aSAH), yet the relationship between serum magnesium (Mg) level and PHH remains unclear. To our knowledge, this is the first prospective study to specifically examine the association between admission serum Mg level and PHH in aSAH patients.
Methods
In this prospective, multicenter study (October 2019–October 2024), 131 patients with confirmed aSAH were enrolled from four neuro-intensive care units. Patients were stratified by admission serum Mg level as <2.2 mg/dL or ≥2.2 mg/dL. The primary outcome was PHH incidence; secondary outcomes were cerebral vasospasm (CV), delayed cerebral ischemia (DCI), and 30-day modified Rankin Scale (mRS) score.
Results
Baseline characteristics were similar between groups. Serum Mg ≥2.2 mg/dL was not significantly associated with reduced vasospasm, DCI, or poor functional outcome. However, serum Mg >2.5 mg/dL correlated with lower PHH incidence in univariate analysis (odds ratio, 0.36; P=0.027) but not in multivariate analysis (P=0.136). Independent predictors of PHH were posterior circulation aneurysm, high Fisher grade, and high Hunt and Hess grade. Poor 30-day mRS was independently associated with high Fisher and Hunt and Hess grades.
Conclusions
Admission serum Mg level was not independently associated with PHH, although a potential protective trend was noted at higher levels (>2.5 mg/dL). These findings suggest a possible role of Mg in PHH prevention. Further prospective trials are warranted to clarify the therapeutic potential of Mg and to establish optimal monitoring and correction strategies in aSAH management.
- Neurosurgery
- The efficacy of therapeutic hypothermia in patients with poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis
- Seungjoo Lee, Moinay Kim, Min-Yong Kwon, Sae Min Kwon, Young San Ko, Yeongu Chung, Wonhyoung Park, Jung Cheol Park, Jae Sung Ahn, Hanwool Jeon, Jihyun Im, Jae Hyun Kim
- Acute Crit Care. 2024;39(2):282-293. Published online May 30, 2024
- DOI: https://doi.org/10.4266/acc.2024.00612
- 7,814 View
- 213 Download
- 5 Web of Science
- 4 Crossref
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Abstract
PDF
Supplementary Material - Background
This study evaluates the effectiveness of Therapeutic Hypothermia (TH) in treating poor-grade aneurysmal subarachnoid hemorrhage (SAH), focusing on functional outcomes, mortality, and complications such as vasospasm, delayed cerebral ischemia (DCI), and hydrocephalus.
Methods
Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a comprehensive literature search was conducted across multiple databases, including Medline, Embase, and Cochrane Central, up to November 2023. Nine studies involving 368 patients were selected based on eligibility criteria focusing on TH in poor-grade SAH patients. Data extraction, bias assessment, and evidence certainty were systematically performed.
Results
The primary analysis of unfavorable outcomes in 271 participants showed no significant difference between the TH and standard care groups (risk ratio [RR], 0.87). However, a significant reduction in vasospasm was observed in the TH group (RR, 0.63) among 174 participants. No significant differences were found in DCI, hydrocephalus, and mortality rates in the respective participant groups.
Conclusions
TH did not significantly improve primary unfavorable outcomes in poor-grade SAH patients. However, the reduction in vasospasm rates indicates potential specific benefits. The absence of significant findings in other secondary outcomes and mortality highlights the need for further research to better understand TH's role in treating this patient population. -
Citations
Citations to this article as recorded by
- Real-World Practice of Target Temperature Management in Acute Brain Injury: Associations with Coagulopathy and In-Hospital Mortality
Young Ju Lee, Jihye Song, Yong Cheol Lim
Therapeutic Hypothermia and Temperature Management.2026;[Epub] CrossRef - Progress of Brain Hypothermia Treatment for Severe Subarachnoid Hemorrhage—177 Cases Experienced and a Narrative Review
Hitoshi Kobata
Therapeutic Hypothermia and Temperature Management.2025; 15(3): 113. CrossRef - State-of-the-art for automated machine learning predicts outcomes in poor-grade aneurysmal subarachnoid hemorrhage using routinely measured laboratory & radiological parameters: coagulation parameters and liver function as key prognosticators
Ali Haider Bangash, Jayro Toledo, Muhammed Amir Essibayi, Neil Haranhalli, Rafael De la Garza Ramos, David J. Altschul, Stavropoula Tjoumakaris, Reza Yassari, Robert M. Starke, Redi Rahmani
Neurosurgical Review.2025;[Epub] CrossRef - Targeted temperature management in acute brain injury
Arjun Joshi, Mark Earl
Anaesthesia & Intensive Care Medicine.2025; 26(10): 639. CrossRef
- Real-World Practice of Target Temperature Management in Acute Brain Injury: Associations with Coagulopathy and In-Hospital Mortality
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