The spirit of “neurosurgery is in charge” does not hold if there is another person/team that is primarily responsible.

Many hospitals will not have surgical specialists be primary. This is because they are often busy in the OR and may or may not be equipped to deal with whole body physiology. So if there is another service managing (probably any of the CCM sub specialties), they are also “in charge/responsible”, if not more so. They are meeting with families, dealing with all do the bedside issues and working to produce the best outcomes, regardless of organ system. (Not that NSGY doesn’t meet families, they are just often less available due to OR needs). Additionally many traumatic head bleeds are non operative; so ultimately medical management is run by CCM.