Fever is a common occurrence in [[aneurysmal subarachnoid hemorrhage]] (70%) especially in poor grades, contributes to adverse outcome and may not always respond to conventional treatment ((Rose MJ. Aneurysmal subarachnoid hemorrhage: An update on the medical complications and treatments strategies seen in these patients. Curr Opin Anaesthesiol. 2011;24:500–7.)). Development of clinical triad of [[fever]], [[vomiting]], and [[headache]] in cases of chronic suppurative [[otitis media]] (CSOM) suggest the intracranial spread of infective pathology. [[Fever]] occurs frequently in acute [[brain injury]] patients, and its occurrence is associated with poorer [[outcome]]s, leading to higher rates of mortality, greater disability, and longer lengths of stay. Although clinical practice guidelines exist for ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury, they lack specificity in their recommendations for fever management, making it difficult to formulate appropriate protocols for care. Using survey methods, the aims of a study were to (a) describe how nursing practices for fever management in this population have changed over the last several years, (b) assess if institutional protocols and nursing judgment follow published national guidelines for fever management in neuroscience patients, and (c) explore whether nurse or institutional characteristics influence decision making. Compared with the previous survey administered in 2007, there was a small increase (8%) in respondents reporting having an institutional fever protocol specific to neurologic patients. Temperatures to initiate treatment either based on protocols or nurse determination did not change from the previous survey. However, nurses with specialty certification and/or working in settings with institutional awards (e.g., Magnet status or Stroke Center Designation) initiated therapy at a lower temperature.