On September 19, 2007, Dr. Stephan Mayer gave an outstanding demonstration of current and future advances in neuro intensive care at our CCM Grand Rounds. Dr. Mayer is Associate Professor of Neurology and Neurosurgery at the Columbia University College of Physicians and Surgeons in NYC. He is also the Director of the Neuro ICU at the New York Presbyterian Hospital of Columbia University Medical Center. In a very crowded room with standing room only, he delivered a most appreciated lecture on CNS monitoring and how to use this information to improve outcome of patients admitted in coma from a variety of causes, from subarachnoidal bleeding to traumatic brain injury. He concentrated on brain tissue oxygen tension representing delivery, diffusion and consumption of oxygen in the brain using the Licox device. He also discussed use of microdialysis in the injured brain, including not only measurement of glucose, lactate and pyruvate but also glutamate as an indicator of brain injury. The many questions asked at the end of the presentation indicated the very strong interest in this topic by the audience.