The speed with which patients who would benefit from neurological and neurosurgical care are identified, referred, and transferred may critically influence their outcome. There is evidence that delays and errors in early management have occurred in those with unfavourable outcome even after transfer to neurosurgical centres. The benefits of specialist neurological care include the availability of skills and facilities for intracranial surgery, expertise for patient assessment, and capability for sophisticated monitoring and management of intracranial pathologies that constitute neurological intensive care (NICU) (Box 2.1). There are also benefits to be accrued in the access to enhanced knowledge and expertise resulting from the concentration of experience.

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