Nontraumatic Neurosurgical Emergencies

Most neurosurgical emergencies involve management of intracranial pressure, decompression of brain parenchyma, or diversion of cerebrospinal fluid. These interventions aim to prevent progression and reverse damage to neural structures. The pathologies that require emergent treatment either develop acutely or may progress over days until they reach a critical point causing decompensation. The risk of any intervention need to be weighed against potential benefits and should involve discussions with the family. Interventions have shown to be effective and facilitate patients' return to improved functionality. However, while neurosurgical interventions are lifesaving, surviving patients may have a severe residual disability. This article presents an overview of commonly seen nontraumatic neurosurgical emergencies. Each section presents key facets of presentation, initial workup, management, and role of surgical intervention.