It varies by hospital culture. In our academic center neurohospitalists usually manage all organ systems of a patient admitted with a primary neurological diagnosis. I manage malignant hypertension, afib, AKI, UTI, ileus routinely. If our patients develop sepsis we move them to our neuroICU where we have neurointensivists to help but we remain the primary attending. However, we feel comfortable consulting other services when things get crazy (liver failure, pancreatitis, decompensated CHF, symptomatic hyperkalemia, etc). In other hospitals, neurologists only consult and patients are cared for primarily by medicine hospitalists.