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“Good judgment is the result of experience and experience the result of bad judgment.” – Mark Twain Intensive care units exist for patients with severe disease, as well as for patients who are expected to be unstable. Unprovoked changes to vital signs, neurological examinations, laboratory results, and imaging are expected in such patients, although some events can be anticipated, rescued, or salvaged. One should know what comes next, how to communicate what has happened, and what is likely to happen next. 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.