1. Different neuroICUs vary considerably. We treat a lot of general critical care issues in ours. ARDS, ARF on CVVH, sepsis, cardiogenic shock, yada yada. But it isn't a MICU, and I rarely start ECMO or use ventricular assist devices on my service, and only would ever do those things with a lot of support. It's just not what we're there for. German NCC is good, multiple groups publish in Neurocrit Care on a regular basis. I definitely feel like more of a generalist than most neurologists, because I rarely need to actually make diagnoses and the physical neurologic examination is much more rudimentary in the ICU population.
2. There are other neurologic specialties that deal with other medical issues as well. Vascular neurologists often have to manage multiple comorbidities, although rarely in a critical care situation. ALS docs are typically very involved in all aspects of care. Neuro-oncologists as well. I'm sure the list goes on from there.
3. We don't do neuroICU consults, and I only see patients that are physically in my ICU. The neuroICU attendings will consult for neurotrauma only. Outside of that, there is a separate neurology consult service that sees consults in the MICU and SICU, and if they think the patient needs neuroICU help then we discuss transferring the patient to the neuroICU. Again, practice varies considerably, and there are several neuroICU services at prominent places that function much more in a consultative role than we do.
