Cover of Neurocritical Guide by Dr. Mohamed Najm
First Edition · 2026 · Free

Neurocritical Guide

A bedside reference for the assessment and management of the unresponsive patient in intensive care

Dr. Mohamed Najm

Download the PDF 5.4 MB View on Zenodo

On a phone, if the download doesn’t start inside Facebook, Instagram or X, open this page in Safari or Chrome first.

What it is

The patient who will not wake up.

What is broken, where is it, and what must be done in the next five minutes? Every page of this guide serves that question.

Written for intensivists, neurologists, emergency physicians, anaesthetists, trainees and critical care nurses who look after unresponsive adults, in a neuro-ICU or a general ICU. Where invasive monitoring or continuous EEG is unavailable, the text says what to do instead. Every threshold, dose and score is tied to a numbered reference.

Pages
72
Structure
9 chapters · 4 appendices
Figures
30+ original figures and tables
Includes
Emergency index, coma documentation template, adult drug reference, bedside cards, 14 self-assessment questions
Evidence
Reviewed to October 2026
Licence
CC BY-NC-ND 4.0 — share freely with credit; no sale or modification
DOI
10.5281/zenodo.23212899
Contents

In the order the problems arrive.

Chapters 1–3Recognise and localise

  1. 1Consciousness  · arousal, awareness, the first hour
  2. 2The bedside examination  · GCS, FOUR, pupils, posturing
  3. 3Brainstem and localisation  · reflexes, herniation, Cushing

Chapters 4–5Pressure and disease

  1. 4Raised intracranial pressure  · SIBICC tiers, osmotherapy, the blown pupil
  2. 5Disease-specific management  · TBI, SAH, ICH, stroke, CNS infection, neuromuscular failure, sodium

Chapters 6–7What hides the examination

  1. 6Conditions that hide the examination  · sedation, delirium, toxic mimics
  2. 7Seizures and status epilepticus  · NCSE, the ICU EEG report

Chapters 8–9The hardest conversations

  1. 8Prognosis and communication  · ERC/ESICM 2025, the family meeting
  2. 9Death by neurological criteria  · prerequisites, apnoea test, ancillary tests
  3. A–DAppendices  · template, drugs, bedside cards, self-assessment
Read with it

The Book of Seizures

The companion title on epilepsy and antiseizure medications. Its pharmacology chapters complement Chapter 7 of this guide.

See the book
How to cite

Najm M. Neurocritical Guide: a bedside reference for the unresponsive patient in intensive care. 1st ed. Zenodo; 2026. https://doi.org/10.5281/zenodo.23212899

Found an error?

Corrections, questions and clinical feedback go to [email protected]. Corrected versions are published under the same DOI, which always opens the latest version.