The Neuro Exam

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Adam Rizvi, a neurocritical care specialist, about neurological examinations in the ICU. Dr. Rizvi explains the importance of neurological exams for bedside critical care clinicians, differentiating between identifying severe emergencies and subtle detective work to prevent long-term issues. The discussion covers the neural axis, localization of injuries, and differences between internal medicine and neurological approaches to diagnosis. Dr. Rizvi provides practical advice for daily neurological assessments, including adapting the standard neuro exam for ICU patients, using the mnemonic "HAND" for cortical signs, and emphasizing the importance of daily SATs and SBTs. The podcast further explores brainstem anatomy and function, coma exams, and evaluation of potential death by neurologic criteria, offering pearls for accurate assessments and highlighting the value of kindness in the ICU environment.