Safely performing neurosurgical procedures during COVID-19 pandemic

Neurol Res. 2020 Oct;42(10):811-817. doi: 10.1080/01616412.2020.1781455. Epub 2020 Jul 1.

Abstract

Introduction: The novel coronavirus disease (COVID-19) pandemic poses a substantial threat to the health of healthcare personnel on the front line of caring for COVID-19 patients. The Centers for Medicare and Medicaid Services previously announced that all non-essential planned surgeries and procedures should be postponed until further notice and only urgent procedures should proceed.

Methods: We share our experiences with safely performing neurosurgical procedures on confirmed and suspected COVID-19 patients, to aide other neurosurgical teams in preparing for these high-risk cases, especially for neurosurgical interventions which are essential at saving a life or preserving functioning of the central nervous system that cannot be delayed. Perioperative and intraoperative strategies, considerations, as well as challenges arisen under the specific circumstance have been discussed: the hospital should be equipped with negative pressure areas and multiple areas to quarantine positive patients; the operating rooms should be negative pressure or have HEPA-filtration systems in place; all healthcare personnel who immediately participate in neurosurgical interventions for confirmed and suspected COVID-19 patients should take airborne precautions and wear enhanced personal protective equipment.

Results: Successful management of neurosurgical emergencies without healthcare personnel infection has been achieved during this pandemic crisis.

Conclusion: Following the proposed guidance, urgent neurosurgical surgeries and procedures can be safely performed for the benefit of critical patients with or suspected for COVID-19.

Keywords: COVID-19; Neurosurgery; coronavirus; neurological procedure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections*
  • Female
  • Humans
  • Male
  • Neurosurgery*
  • Neurosurgical Procedures*
  • Occupational Exposure / prevention & control*
  • Occupational Health*
  • Pandemics*
  • Pneumonia, Viral*
  • SARS-CoV-2