NCC Exam Format | Course Contents | Outline | Syllabus | Objectives

NCC Exam Syllabus & Study Guide

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The information below reflects the 2026 syllabus defined by ABEM.

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ABEM NCC Certified in NeuroCritical Care I. Neurological Critical Care A. Cerebrovascular Diseases - Infarction and ischemia - Massive hemispheric infarction - Basilar artery occlusion and stenosis - Carotid artery occlusion and stenosis - Crescendo TIAs - Occlusive vasculopathies (Moya-Moya, sickle cell) - Spinal cord infarction - Intracerebral hemorrhage - Supratentorial - Cerebellar - Brainstem - Intraventricular - Subarachnoid hemorrhage - (aneurysmal and other vascular malformations) - Arteriovenous malformations - AV fistulas - Cavernous malformations - Developmental venous anomalies - Dural sinus thrombosis - Carotid-cavernous fistulae - Cervical and cerebral arterial dissections B. Neurotrauma - Traumatic brain injury - Diffuse axonal injury - Epidural hematoma - Subdural hematoma - Skull fracture - Contusions and lacerations - Penetrating craniocerebral injuries - Traumatic subarachnoid hemorrhage - Spinal cord injury - Traumatic injury (transection, contusion, concussion) - Vertebral fracture and ligamentous instability C. Disorders, Diseases, Seizures, and Epilepsy - Seizures and epilepsy - Status epilepticus (SE) (Convulsive, non-convulsive, myoclonic) - Neuromuscular diseases - Myasthenia gravis - Guillain-Barre syndrome - ALS - Rhabdomyolysis and toxic myopathies - Critical illness myopathy and neuropathy - Infections - Encephalitis (viral, bacterial, parasitic) - Meningitis (viral, bacterial, parasitic) - Brain and spinal epidural abscess - Toxic-metabolic disorders - Neuroleptic malignant syndrome/malignant hyperthermia - Serotonin syndrome - Drug overdose and withdrawal (e.g., barbiturates, narcotics, alcohol, cocaine, acetaminophen) - Temperature-related injuries (hyperthermia, hypothermia) - Inflammatory and demyelinating diseases - Multiple sclerosis (Marburg variant, transverse myelitis) - Neurosarcoidosis - Acute disseminated encephalomyelitis (ADEM) - CNS vasculitis - Chemical or sterile meningitis (i.e., posterior fossa syndrome, NSAID-induced) - Central pontine myelinolysis - Others - Neuroendocrine disorders - Pituitary apoplexy - Diabetes insipidus (including triple phase response) - Panhypopituitarism - Thyroid storm and coma - Myxedema coma - Addisonian crisis D. Neuro-oncology - Brain tumors and metastases - Spinal cord tumors and metastases - Carcinomatous meningitis - Paraneoplastic syndromes E. Encephalopathies - Eclampsia (including HELLP Syndrome) - Hypertensive encephalopathy - Hepatic encephalopathy - Uremic encephalopathy - Hypoxic-ischemic and anoxic encephalopathy - MELAS F. Clinical Syndromes - Coma - Herniation syndromes with monitoring & ICP - Elevated intracranial pressure and intracranial hypotension/hypovolemia - Hydrocephalus detection & treatment - Cord compression - Death by neurologic criteria, end-of-life issues, and organ donation - Vegetative state - Dysautonomia (cardiovascular instability, central fever, hyperventilation) - Reversible posterior leukoencephalopathy - Psychiatric emergencies (psychosis) G. Perioperative Neurosurgical Care H. Pharmacotherapeutics II. General Critical Care: Pathology, Pathophysiology, and Therapy A. Cardiovascular Physiology and Therapy - Shock (hypotension) and its complications (vasodilatory and cardiogenic) - Myocardial infarction and unstable coronary syndromes - Neurogenic cardiac disturbances (ECG changes, stunned myocardium) - Cardiac rhythm and conduction disturbances (antiarrhythmics, pacemakers) - Pulmonary embolism - Pulmonary edema (cardiogenic vs. noncardiogenic/neurogenic) - Acute aortic and peripheral vascular disorders - Management of hypertensive emergencies and urgencies - Calculation of derived cardiovascular parameters B. Respiratory Physiology and Therapy - Acute respiratory failure (hypoxemic/ARDS, hypercapnic, neuromuscular) - Aspiration - Bronchopulmonary infections - Upper airway obstruction - COPD and status asthmaticus - Neurogenic breathing patterns - Mechanical ventilation (BIPAP, PEEP, CPAP, pressure support/control, negative pressure, barotrauma, weaning) - Pleural diseases (empyema, massive effusion, pneumothorax) - Pulmonary hemorrhage and massive hemoptysis - Chest X-ray interpretation - End-tidal $CO_2$ monitoring - Sleep apnea - Control of breathing C. Renal Physiology and Therapy - Regulation of fluid, water balance, and electrolytes - Renal failure (prerenal, renal, postrenal) - Derangements in osmolality and electrolytes - Acid-base disorders - Principles of renal replacement therapy - Evaluation of oliguria and polyuria - Drug dosing in renal failure - Management of rhabdomyolysis - Neurogenic disorders of sodium/water (cerebral salt wasting and SIADH) D. Metabolic and Endocrine Effects of Critical Illness - Enteral and parenteral nutrition - Endocrinology (thyroid dysfunction, adrenal crisis, diabetes mellitus, hypoglycemia) - Disorders of calcium and magnesium balance - Systemic Inflammatory Response Syndrome (SIRS) - Fever, thermoregulation, and cooling techniques E. Infectious Disease - Antibiotics (antibacterial, antifungal, antituberculosis, antiviral, antiparasitic) - Infection control (resistance, precautions, isolation) - Tetanus and botulism - Hospital-acquired and opportunistic infections - Acquired Immune Deficiency Syndrome (AIDS) - Evaluation of fever in ICU / Central fever - Interpretation of antibiotic concentrations/sensitivities F. Acute Hematologic Disorders - Acute defects in hemostasis (thrombocytopenia, DIC, acute hemorrhage, iatrogenic coagulopathies) - Anticoagulation and fibrinolytic therapy - Principles of blood component therapy - Hemostatic therapy (vitamin K, aminocaproic acid, protamine, factor VIIa) - Prophylaxis against thromboembolic disease - Prothrombotic states G. Acute Gastrointestinal (GI) and Genitourinary (GU) Disorders - GI bleeding (upper and lower) - Acute/fulminant hepatic failure - Ileus and toxic megacolon - Acute perforations - Acute vascular disorders (mesenteric infarction) - Acute intestinal obstruction, volvulus - Pancreatitis - Obstructive uropathy, acute urinary retention - Urinary tract bleeding H. Immunology and Transplantation - Principles of transplantation (brain death, donation, procurement, maintenance, implantation) - Immunosuppression (and neurotoxicity) I. General Trauma and Burns - Initial approach to multisystem trauma - Skeletal trauma (spine and pelvis) - Chest and abdominal trauma (blunt/penetrating) - Burns and electrical injury J. Monitoring - Neuromonitoring - Prognostic, severity, and therapeutic scores - Electrocardiographic monitoring - Invasive/noninvasive hemodynamic monitoring - Respiratory monitoring - Metabolic monitoring - Use of computers for multimodality monitoring K. Administrative and Management Principles - Organization and staffing - Collaborative practice/multidisciplinary rounds - Emergency medical systems (prehospital) - Performance improvement - Triage and resource allocation - Medical economics (reimbursement, budget) L. Ethical and Legal Aspects - Death and dying - Forgoing life-sustaining treatment (DNR) - Rights of patients (refusal of treatment) - Living wills, advance directives, power of attorney - Terminal extubation and palliative care - Rationing and cost containment - Emotional management of patients/families - Futility of care M. Principles of Research - Study design - Biostatistics - Grant funding and protocol writing - Manuscript preparation - Presentation skills - IRBs and HIPAA III. Procedural Skills - Central venous/dialysis catheter placement - Pulmonary artery catheterization - Mechanical ventilation management (CPAP/BiPAP) - Vasoactive medication administration - Airway maintenance in nonintubated patients - Bedside pulmonary function tests - Direct laryngoscopy - Endotracheal intubation - Shunt and ventricular drain tap - Transcranial Doppler - Analgosedative administration (conscious sedation/barbiturate anesthesia) - Continuous EEG monitoring interpretation - ICP and CPP data management - Jugular venous bulb catheterization - $SjvO_2$ and $PbtO_2$ data interpretation - External ventricular drain management - Plasmapheresis and IVIG management - Intravenous and intraventricular thrombolysis - CT/MR neuroimaging and perfusion studies/angiography - Perioperative clinical evaluation of neurosurgical patients - Lumbar puncture and CSF analysis - Therapeutic coma and hypothermia induction/maintenance