Clinical decision support tools exist in neurocritical care, but none fully integrate real-time physiological data. We developed a proof-of-concept expert system that links neurological medications, monitoring modalities, and guideline-based thresholds. Using an ontology of ICU medications and physiological metrics, the system categorizes conditions and pre-conditions to advise clinical actions. Evaluated with a simulator and Moberg CNS monitor, it demonstrated feasibility in real-time decision support. Future work will expand the knowledge base to enhance neurophysiological monitoring and assist treatment decisions.