The investigators aim to compare the complications between centrally and peripherally inserted central venous catheters in neurological intensive care unit patients. The study hypothesis is that peripherally inserted catheters will have more cumulative complications due to venous thrombosis.

Inclusion Criteria:

• all patients age > 18, admitted to the neurological ICU who are require a de novo central venous catheter as standard of care and in which a double lumen 5f PICC or CICVC (triple lumen, 7f) are acceptable for the indication.
• the patients must be expected to survive and need a central venous catheter for at least 7 days.

Exclusion Criteria:

• prisoner
• age < 18
• expected to die or have care withdrawn prior to ICU day 7
• requiring an emergent central venous catheter
• suspected bacteremia
• recent central venous catheter within the last 30 days
• patients who are not a candidate for bedside placement of either a CICVC or PICC line
• patients with renal insufficiency with creatinine level greater than 3.0 mg/dL (265.2 m mol/L) or who were undergoing hemodialysis
• patients requiring a central venous catheter for prolonged antibiotic therapy\
• patient who the treating clinician feels clearly needs one particular type of catheter over the other