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Neurocritical Care Past, Present, and Future

      The recognition of neurocritical care as an Accreditation Council for Graduate Medical Education (ACGME) -accredited subspecialty in 2021 marked a crowning moment for the many pioneers and visionaries who have deliberately persevered toward this status. A glimpse into the development of neurocritical care education is included as many institutions seek to add ACGME accreditation to their existing programs.
      Neurocritical Care research is a rapidly expanding area that focuses on crucial clinical issues and the need to understand gaps in our current knowledge. The Curing Coma Campaign underway by the Neurocritical Care Society is one example of the vast international and multidisciplinary research collaborations in the field.
      With respect to the practice of neurocritical care, we review fundamentals for bedside management as well as the state of the science for acute ischemic stroke, subarachnoid and intracerebral hemorrhage, status epilepticus, neurotrauma and elevated intracranial pressure, death by neurologic criteria, neuromuscular weakness, neuroprognostication, neurocritical care in the general ICU, neuropharmacology, multimodal monitoring, and the emerging field of big data science and artificial intelligence in neurocritical care. Technology and advanced diagnostics are opening new avenues of investigation and patient care. In summary, the future of the field is bright with ongoing rapid scientific discovery in all areas. We are both honored and excited for this opportunity to provide a review of our specialty, updates in clinical care of critically ill neurologic patients, and a glimpse into some of the advances in our field with the readers.