# bib

id: cord-027854-o511h1my
title: Letter to the Editor: SARS-CoV-2 and Traumatic Cervical Acute Spinal Cord Injury: An Appraisal
author: Moscote-Salazar, Luis Rafael
date: 2020-06-25
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url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315159/
doi: 10.1016/j.wneu.2020.06.134
abstract: nan
summary:
  authors: Moscote-Salazar, Luis Rafael; Galindo-Velasquez, Hather; Garcia-Ballestas, Ezequiel; Agrawal, Amit; Rahman, Md Moshiur; Sarwar, A.S.M. title: Letter to the Editor: SARS-CoV-2 and Traumatic Cervical Acute Spinal Cord Injury: An Appraisal In patients infected with coronavirus and suffering from a traumatic spinal injury. We have to remember the importance of neurogenic shock, defined as the autonomic dysregulation due to the sudden loss of control of the sympathetic tone and the overlapping of a parasympathetic response that appears in the context of a spinal cord injury. 11 Regarding the latter, it should be thoroughly investigated what is the actual role of the virus during the pathophysiology of the acute spinal cord injury and how it can affect the outcomes, and prognosis of the patient. Emergency Neurological Life Support: Traumatic Spine Injury Early neurological care of patients with spinal cord injury


id: cord-252661-wa0hdg1u
title: Letter: Changes to neurosurgery resident education following onset of the COVID-19 pandemic
author: Pennington, Zach
date: 2020-05-22
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url: https://doi.org/10.1016/j.wneu.2020.05.139
doi: 10.1016/j.wneu.2020.05.139
summary:
  Here we surveyed program directors 6 (PDs) to ascertain how they have altered the education and clinical care responsibilities of 7 residents in response to the COVID-19 pandemic. Continuing education in spite of decreased case 21 volume and maintaining resident morale are cited as the most common concerns of PDs. 22 23 Conclusion 24 Here we find that there is great homogeneity in the responses of neurosurgical residency 25 programs to the COVID-19 pandemic. Continuing education in spite of decreased case 21 volume and maintaining resident morale are cited as the most common concerns of PDs. 22 23 Conclusion 24 Here we find that there is great homogeneity in the responses of neurosurgical residency 25 programs to the COVID-19 pandemic. Here we present the results of a survey of PDs for ACGME-accredited neurosurgery residency 126 programs regarding their responses to the COVID-19 pandemic.

abstract:
  Abstract Background The COVID-19 pandemic has led to the postponement of a large proportion of neurosurgical cases with an accordant radical change in resident experiences. As residents rely upon operative exposure and in-person didactic lectures for education, the disruptions caused by the pandemic have forced programs to revise how they educate residents. Here we surveyed program directors (PDs) to ascertain how they have altered the education and clinical care responsibilities of residents in response to the COVID-19 pandemic. Methods Surveys were sent to the PDs of all ACGME-accredited neurosurgery programs. Survey questions targeted changes in resident staffing and coverage, changes in didactic material delivery, and changes in resident wellness initiatives. PD concerns were also elicited. Results Of the 116 program PDs invited, 57 responded (49.1%). We found that most programs have reduced resident work weeks (65%) and in-hospital resident shift census (95%). Few have redeployed residents and most are increasingly relying on teleconferencing solutions for meetings and resident education. Most commonly programs are using faculty- (91%) or resident-led (65%) lectures, though nearly 75% are supplementing resident education with materials from the Congress of Neurological Surgeons (CNS). Continuing education in spite of decreased case volume and maintaining resident morale are cited as the most common concerns of PDs. Conclusion Here we find that there is great homogeneity in the responses of neurosurgical residency programs to the COVID-19 pandemic. Programs are increasingly incorporating teleconferencing platforms and third-party education materials, most commonly materials from the CNS. Additionally, most respondents indicated that their program has not redeployed residents in the care of COVID-19 positive patients. The results of the present study may assist program directors in developing a uniform resident curriculum and consider wellness initiatives during this time of crisis.


id: cord-253318-nlk8pjv2
author: Roberti, Fabio
date: 2020-05-06
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url: https://api.elsevier.com/content/article/pii/S1878875020309451
doi: 10.1016/j.wneu.2020.04.235
summary:
  Abstract We present a case of symptomatic heterotopic bone formation following revision of posterolateral lumbar fusion/instrumentation and "off-label" use of recombinant human bone morphogenetic protein-2 (rhBMP-2), treated successfully with the use of a minimally invasive tubular approach. We report a case of symptomatic heterotopic bone formation following lumbar spinal revision surgery and posterolateral fusion with rhBMP-2, successfully treated using a minimally invasive tubular approach and provide documentation of the technical aspect of the procedure. In light of the absence of significant low back pain, the predominance of radicular symptoms, the absence of mechanical instability and the presence of bilateral facet arthrodesis, as well as the history of previous lumbar surgeries and associated medical comorbidities, we felt a minimally invasive approach was an appropriate option to be selected in this case and the patients concurred with this informed decision. In the presented case we found the use of minimally invasive techniques to be of benefit for the removal of heterotopic bone formation following lumbar spine fusion with rhBMP-2.

title:
  Minimally invasive lumbar decompression and removal of symptomatic Heterotopic bone formation after spinal fusion with rhBMP-2

abstract:
  Abstract We present a case of symptomatic heterotopic bone formation following revision of posterolateral lumbar fusion/instrumentation and “off-label” use of recombinant human bone morphogenetic protein-2 (rhBMP-2), treated successfully with the use of a minimally invasive tubular approach.


id: cord-256117-t9v1hng5
author: Al Kasab, Sami
date: 2020-06-03
txt: ./txt/cord-256117-t9v1hng5.txt
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url: https://doi.org/10.1016/j.wneu.2020.04.153
doi: 10.1016/j.wneu.2020.04.153
abstract: nan
summary:
  Even for patients in whom an LVO is confirmed, the criteria for transfer to the thrombectomy capable center should be decided on by a multidisciplinary team. Pre-thrombectomy screening for COVID-19 is a major challenge; often these patients are unable to provide a history and collateral information is typically lacking. Although extending the CT to capture the entire chest entails additional radiation, identifying a lung infiltrate suggestive of likely COVID-19 infection in an asymptomatic patient affords the health care team the ability to don the proper precautions before the procedure. Thrombectomy in and of itself is a low-risk procedure for contracting the virus, whereas the intubation and extubation are by far the greatest-risk components and would incur additional risk to your ED and neuro-intensive care unit (ICU) colleagues, respectively. The lowest-risk pathway to the system as a whole is to get the LVO patient through the thrombectomy awake and cooperative without requiring pre-procedure intubation.

title:
  Acute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic: From Trough of Disillusionment to Slope of Enlightenment


id: cord-258293-7q9zj8c2
author: Marini, Alessandra
date: 2020-05-26
txt: ./txt/cord-258293-7q9zj8c2.txt
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url: https://www.sciencedirect.com/science/article/pii/S1878875020311311?v=s5
doi: 10.1016/j.wneu.2020.05.160
abstract: nan
summary:
  with intracranial or spinal oncological pathology (rapidly evolving intracranial hypertension with deteriorating 4 state of consciousness, acute hydrocephalus, spinal cord compression with rapid tetra or paraparesis); Class A + 5 are the patients who requirie treatment within a maximum of 7-10 days, with intracranial tumors with mass 6 effect or with progressive neurological deficit, without deterioration of consciousness and patients requiring 7 treatment within a month, namely Class A, with neurological alteration or suspected malignant lesion, related 8 This resulted in progression of the neurological 4 symptoms, without an early neurosurgical evaluation, until the onset of acute deficit which actually led to the 5 emergency room access. symptoms were consciousness alteration and seizures; in our survey approximately 10,7 % of the acute-onset 0 patients reported to have previously refused the surgical treatment, in the weeks before, correlated to concerns 1 about the hospitalization during the Coronavirus emergency. In conclusion, during the COVID-19 pandemic the neurosurgical urgent and emergency onset of neuro-6 oncological cases increased, in comparison to 2019. Illustrative Table regarding the epidemiological variations in neuro-oncological patients'' onset during the COVID-19 crisis

title:
  Letter to the Editor Regarding ''Coronavirus Disease 2019 (COVID-19) and Neurosurgery: Literature and Neurosurgical Societies Recommendations Update''


id: cord-258344-55n3wwle
author: Khalafallah, Adham M.
date: 2020-08-08
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url: https://doi.org/10.1016/j.wneu.2020.08.033
doi: 10.1016/j.wneu.2020.08.033
abstract: nan
summary:
  title: In Reply to the Letter to the Editor Regarding "Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience" The authors thank Dr. Venkataram and colleagues for their thoughtful and thorough 1 analysis of our recent study "Impact of COVID-19 on an Academic Neurosurgery Department: 2 The Johns Hopkins Experience." 1 As stated in our paper, we believe that publishing the unique 3 experiences of different academic medical centers during the COVID-19 pandemic is essential in 4 clarifying the many challenges facing both American neurosurgery as well as neurosurgery 5 across the world, and we also believe sharing such information is important for establishing a 6 consensus regarding best practices as the situation continues to evolve. Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans

title:
  In Reply to the Letter to the Editor Regarding “Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience”


id: cord-258562-raubqnko
author: Murlimanju, Bukkambudhi V.
date: 2020-09-23
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url: https://api.elsevier.com/content/article/pii/S1878875020315308
doi: 10.1016/j.wneu.2020.07.019
abstract: nan
summary:
  title: Letter to Editor Regarding: "Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt" Letter to Editor Regarding: "Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt" C oronavirus disease 2019 has undoubtedly placed many unprecedented restrictions on the life of current generations globally. The effects have been adverse in several aspects, including the decreased number of clinical cases per specialty, staff reductions, cancellation of academic conferences, and the difficulty in conducting training and licensing examinations. 1 that to address the decrease in learning resources during neurosurgery residency training and, as the authors have rightly suggested, that the residency program must be able to adapt such unforeseen circumstances. The global leaders in academia should take this COVID-19 pandemic as an opportunity to formulate long-term policies and appropriate pathways to address the new challenges faced by resident training programs. Decrease in neurosurgical program volume during COVID-19: residency programs must adapt Decrease in trauma admissions with COVID-19 pandemic

title:
  Letter to Editor Regarding: “Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt”


id: cord-265172-rn9pkk52
author: Michiwaki, Yuhei
date: 2020-10-09
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url: https://doi.org/10.1016/j.wneu.2020.09.166
doi: 10.1016/j.wneu.2020.09.166
summary:
  title: Emergent carotid artery stenting following intravenous alteplase infusion after rapid negative diagnosis for COVID-19 by loop-mediated isothermal amplification assay: A case report Conclusions This case report suggests that eCAS for hAIS due to ICS following intravenous alteplase can be an effective treatment, along with appropriate antiplatelet medication and management in select patients. This case report suggests that eCAS for hAIS due to ICS following intravenous alteplase can be an effective treatment, along with appropriate antiplatelet medication and management in select patients. Carotid artery stenting (CAS) is a standard treatment procedure for internal carotid artery stenosis (ICS) 8 ; however, the efficacy and safety of emergent CAS (eCAS) for hyperacute ischemic stroke (hAIS) due to ICS have not been sufficiently established. This case report demonstrates that eCAS for AIS due to ICS following intravenous alteplase infusion can be an effective treatment option along with appropriate antiplatelet medication and management in select patients.

title:
  Emergent carotid artery stenting following intravenous alteplase infusion after rapid negative diagnosis for COVID-19 by loop-mediated isothermal amplification assay: A case report

abstract:
  Background During the coronavirus disease 2019 (COVID-19) pandemic, a rapid screening method for COVID-19 detection is needed to decide the appropriate strategy to treat stroke patients. In acute ischemic stroke treatment, the efficacy and safety of emergent carotid artery stenting (eCAS) for hyperacute ischemic stroke (hAIS) due to internal carotid artery stenosis (ICS) have not been sufficiently established. Case Description A 71-year-old man with hAIS caused by severe ICS was treated via intravenous alteplase infusion. The patient underwent screening for COVID-19 by the loop-mediated isothermal amplification (LAMP) assay shortly after arrival at our institution. The LAMP result was obtained within 90 minutes, during intravenous alteplase infusion, and turned out to be negative. The symptom of hemiplegia worsened during alteplase infusion, and he, therefore, underwent eCAS after administration of aspirin (200 mg). Recanalization was achieved successfully by eCAS, and dual antiplatelet therapy and argatroban were administrated following eCAS. Hemorrhagic complications or re-stenosis/occlusion of the carotid artery were not observed. He was discharged without neurological deficits 15 days following eCAS. Because of the rapid negative diagnosis for COVID-19 using the LAMP method, eCAS could be performed following standard procedures, along with infectious defense, without delay. Conclusions This case report suggests that eCAS for hAIS due to ICS following intravenous alteplase can be an effective treatment, along with appropriate antiplatelet medication and management in select patients. During the COVID-19 pandemic, the LAMP assay for COVID-19 detection might be a suitable diagnostic strategy preceding stroke treatment because of the rapid turnaround time.


id: cord-266764-q2vtrs95
author: Munusamy, Thangaraj
date: 2020-09-18
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url: https://www.sciencedirect.com/science/article/pii/S1878875020320842?v=s5
doi: 10.1016/j.wneu.2020.09.076
summary:
  title: Telemedicine via Smart Glasses in Critical Care of the Neurosurgical Patient – A COVID-19 Pandemic Preparedness and Response in Neurosurgery The goal of our study was to determine if telemedicine delivered through smart glasses was feasible and effective in an alternative method of conducting ward round on neurocritical care patients during the pandemic. A virtual ward round was first conducted remotely by a specialist who received real-time audiovisual information from a resident wearing smart glasses integrated with telemedicine. Conclusions Virtual ward rounds using telemedicine via smart glasses on neurosurgical patients in critical care were feasible, effective and widely accepted as an alternative to physical ward rounds during the COVID-19 pandemic. By using the smart glasses, specialists monitoring the ward rounds were able to direct residents and junior staff members through the routine daily review of patients requiring critical care.

title:
  Telemedicine via Smart Glasses in Critical Care of the Neurosurgical Patient – A COVID-19 Pandemic Preparedness and Response in Neurosurgery

abstract:
  Objective The COVID-19 pandemic poses major risks to healthcare workers in neurocritical care. Recommendations are in place to limit medical personnel attending to the neurosurgical patient as a protective measure and to conserve personal protective equipment. However, the complexity of the neurosurgical patient proves to be a challenge and an opportunity for innovation. The goal of our study was to determine if telemedicine delivered through smart glasses was feasible and effective in an alternative method of conducting ward round on neurocritical care patients during the pandemic. Methods A random pair of Neurosurgery resident and specialist conducted consecutive virtual and physical ward rounds on neurocritical patients. A virtual ward round was first conducted remotely by a specialist who received real-time audiovisual information from a resident wearing smart glasses integrated with telemedicine. Subsequently, a physical ward round was performed together by the resident and specialist on the same patient. The management plans of both ward rounds were compared and the intrarater reliability was measured. On study completion a qualitative survey was performed. Results Ten paired ward rounds were performed on 103 neurocritical care patients with excellent overall intrarater reliability. Nine out of ten showed good to excellent internal consistency and one showed acceptable internal consistency. Qualitative analysis indicated wide user acceptance and high satisfaction rate with the alternative method. Conclusions Virtual ward rounds using telemedicine via smart glasses on neurosurgical patients in critical care were feasible, effective and widely accepted as an alternative to physical ward rounds during the COVID-19 pandemic.


id: cord-267579-gkvd0fol
author: Yang, Xiaoyu
date: 2020-07-27
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url: https://doi.org/10.1016/j.wneu.2020.07.144
doi: 10.1016/j.wneu.2020.07.144
abstract: nan
summary:
  title: Asymptomatic Carrier Transmission of COVID-19 and The Multi-Point Aerosol Sampling to Assess Risks in OR During Pandemic Period The 2019 novel coronavirus disease (COVID-19) causing acute infectious pneumonia has widely spread in China and other countries in the world. Studies have documented that novel coronavirus spread through human-to-human transmission in hospital and family setting 2,3 . Nevertheless, the transmission of the novel coronavirus from an asymptomatic carrier should be considered as a source of the infection of COVID-19 as well 4 . Therefore, it is of significance to identify and isolate asymptomatic carriers as well as patients with mild symptoms to prevent the spread of the virus. Clinical Characteristics of Coronavirus Disease 2019 in China Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients

title:
  Asymptomatic Carrier Transmission of COVID-19 and The Multi-Point Aerosol Sampling to Assess Risks in OR During Pandemic Period


id: cord-267618-ots27qks
author: Molliqaj, Granit
date: 2020-05-08
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url: https://doi.org/10.1016/j.wneu.2020.04.149
doi: 10.1016/j.wneu.2020.04.149
abstract: nan
summary:
  title: How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center Q1Q11 Q12 Q13 Q10 Granit Molliqaj and Karl Schaller BACKGROUND Who could have imagined that a virus in the 21st century could so quickly destabilize the world? 1 Nonetheless, on 30 January in Geneva, Switzerland, the Director-General of the World Health Organization made public that the outbreak of the new coronavirus 2019 met the criteria of a public health emergency of international concern. To date, Easter Monday (13 April 2020), more than 25,000 COVID-19Àpositive cases have been confirmed in laboratories and 884 deaths have been recorded for COVID-19 according to the Federal Office of Public Health (Figures 1 and 2) , and these numbers are steadily increasing.

title:
  How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center


id: cord-268939-ws74xprt
title: Neurosurgery Practice During Coronavirus Disease 2019 (COVID-19) Pandemic
author: Ozoner, Baris
date: 2020-05-28
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url: https://api.elsevier.com/content/article/pii/S1878875020311669
doi: 10.1016/j.wneu.2020.05.195
summary:
  The increased burden has substantially impacted the neurosurgery practice and intensive modifications were required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even academic activities. Operations of COVID-19 positive patients, and emergency cases, where screening can not be obtained, should be performed following level 3 protective measures. [5] [6] [7] In neurosurgery practice, intensive modifications were required in surgical scheduling, administration of inpatient and outpatient clinics, management of emergency cases, and even academic & educational activities. 26 A recent study from Wuhan City, China reported that some severe COVID-19 patients developed neurologic manifestations, such as acute cerebrovascular diseases (5.7%), and impaired consciousness (14.8%). 76, 80 Also, a patient with a mass lesion in the sellar region that underwent endonasal endoscopic surgery in Neurosurgery Department, Tongji Medical College, Wuhan City, China was diagnosed with COVID-19 after surgery, and disease was confirmed in 14 healthcare professionals in the same clinic afterwards.

abstract:
  Abstract Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly contagious, life-threatening condition with unprecedented impacts for worldwide societies and healthcare systems. Since the first detection in China, it has spread rapidly worldwide. The increased burden has substantially impacted the neurosurgery practice and intensive modifications were required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even academic activities. In some systems, non-overlapping teams were created to minimize transmission among healthcare workers. In case of a massive burden, neurosurgeons may be needed to reassign to the COVID-19 wards, or teams from other regions may be needed to send to severely affected areas. In outpatient practice, if possible, appointments should be turned into telemedicine. All staff assigned in the non-COVID treatment unit should be clothed in level 1 personal protective equipment. If possible, postponement is recommended for operations that do not require urgent or emergent intervention. All patients indicated for surgery must receive a COVID-19 screening, including nasopharyngeal swab, and thorax computed tomography. Level 2 protection measures would be appropriate during COVID-19 negative patients' operations. Operations of COVID-19 positive patients, and emergency cases, where screening can not be obtained, should be performed following level 3 protective measures. During surgery, the use of high-speed drills and electrocautery should be reduced to minimize aerosol production. Screening is crucial in all patients since the surgical outcome is highly mortal in COVID-19 patients. All educational and academic conferences can be turned into virtual webinars.


id: cord-270525-nmebqrb1
title: Response to SARS-CoV-2 Pandemic in a Non-COVID-19 Designated Latin-American Neurosurgery Department
author: Núñez-Velasco, Santiago
date: 2020-05-11
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url: https://www.sciencedirect.com/science/article/pii/S1878875020309797?v=s5
doi: 10.1016/j.wneu.2020.05.019
summary:
  METHODS An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Based on the epidemiological and biological information available in the literature on COVID-19, specific measures adapted to our resources were implemented to design a protocol of organized administration of human resources both assistant and administrative, optimized surgical procedures, proper handling of personal protective equipment and adaptation of the facilities of the neurosurgery department of the FAAHC when treating neurosurgical patients with no SARS-CoV-2 known condition. This would lead us to a catastrophic scenario because there are reports of a 12% of hospital-associated transmission of the virus as the mechanism of infection of patients, that in our case are weak and many of them immunosuppressed; thus, cases of contamination of health-care personnel have also been reported, especially in non-designated COVID areas in which precautions might relax.

abstract:
  BACKGROUND Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals. METHODS An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. RESULTS Distancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility. CONCLUSIONS Despite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.


id: cord-271840-cw2xy1m6
author: Majmundar, Neil
date: 2020-09-23
txt: ./txt/cord-271840-cw2xy1m6.txt
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url: https://doi.org/10.1016/j.wneu.2020.07.158
doi: 10.1016/j.wneu.2020.07.158
abstract: nan
summary:
  4 reported 5 patients positive for COVID-19 in a New York City hospital system who presented with strokes secondary to largevessel occlusions (LVOs) over a 2-week period despite very few or no risk factors for stroke. Due to the high rates of nosocomial transmission as well as the potential for overwhelming hospital resources, stroke centers across the world implemented new protocols for the triaging of patients with stroke, particularly those with LVOs requiring MT. 8 A recent study from a single center in New Jersey, one of the most heavily COVID-impacted states in the country, corroborated the decrease in overall stroke volume but also found a greater proportion of patients with stroke presenting with LVOs during the COVID-19 period. Although the overall incidence of AIS in COVID-19 is not clear, there is emerging evidence that the rate of LVOs is increased in patients with COVID-19 who may not have the typical stroke risk factors.

title:
  Incidence, Pathophysiology, and Impact of Coronavirus Disease 2019 (COVID-19) on Acute Ischemic Stroke


id: cord-273522-ygd19p05
title: By the Numbers Analysis of COVID-19’s Effect on a Neurosurgical Residency at the Epicenter
author: Rothrock, Robert J.
date: 2020-07-17
txt: ./txt/cord-273522-ygd19p05.txt
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url: https://doi.org/10.1016/j.wneu.2020.07.063
doi: 10.1016/j.wneu.2020.07.063
summary:
  Objective To present areal-world analysis of neurosurgical volumes, resident deployment, and unique challenges encountered during the SARS-CoV-2 outbreak peak in New York City. Methods Daily census and case volume data were prospectively collected throughout the Spring 2020SARS-CoV-2 outbreak. Conclusion These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-19 outbreak. Daily census and case volume data were prospectively collected throughout the Spring 12 2020SARS-CoV-2 outbreak. These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-27 19 outbreak. 55 We report numerical real-world analysis of our neurosurgical resident experience during 56 the peak of the SARS-CoV-2 outbreak in New York City. Understanding volume and case mix 57 of operative and neurointerventional procedures, daily patient census, ICU coverage needs, and 58 rate of resident safety concerns and sick days during this period will aid in understanding 59 resource allocation during future outbreaks.

abstract:
  Abstract Background The SARS-CoV-2 pandemic has created challenges to neurosurgical patient care. Despite editorials evaluating neurosurgery COVID-19 responses, data reporting COVID-19’s effects on case volume, census, and resident illness are lacking. Objective To present areal-world analysis of neurosurgical volumes, resident deployment, and unique challenges encountered during the SARS-CoV-2 outbreak peak in New York City. Methods Daily census and case volume data were prospectively collected throughout the Spring 2020SARS-CoV-2 outbreak. Neurosurgical census was compared against COVID-19 system-wide data. Neurosurgical cases during the crisis were analyzed and compared to seven-week periods from 2019 and 2020. Resident deployment and illness were reviewed. Results From March 16-May 5, 2020, residents participated in 72 operations and 69 endovascular procedures. This compares to 448 operations and 253 endovascular procedures in January-February 2020 and 530 operations and 340 endovascular procedures over March-May 2019. There was a 59% reduction in neurosurgical census during the outbreak (median 24 patients, 2.75 average total cases daily). COVID-19 neurosurgical admissions peaked in concert with the system-wide pandemic. Three residents demonstrated COVID-19 symptomatology (no hospitalizations occurred) for a total 24 workdays lost (median 7 days). Conclusion These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-19 outbreak. While re-deployment to support the COVID-19 response was required, there remained a significant need to continue to provide critical neurosurgical service.


id: cord-274408-3q6jibl8
title: Neurosurgical operative videos: an analysis of an increasingly popular educational resource
author: Knopf, Joshua D.
date: 2020-09-02
txt: ./txt/cord-274408-3q6jibl8.txt
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mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020319562
doi: 10.1016/j.wneu.2020.08.187
summary:
  Objective Surgical education has increasingly relied upon electronic learning, and in particular, online operative videos have become a core resource within the field of neurosurgery. 23 Using edited J o u r n a l P r e -p r o o f operative videos to continually review the technical steps performed by master neurosurgeons is key to refining the science, as well as the art of neurosurgery throughout our careers. 15 Whether used by neurosurgical trainees or established attendings, web-based operative videos appear to play an important role globally, particularly in low-to-middle income countries where limited resources restrict the access of many surgeons to journals, cadaver labs, workshops, and conferences. Our study also demonstrates that in addition to geographic consolidation, the operative videos are heavily weighted toward several neurosurgical subspecialties-tumor, vascular, and skull base in particular-which account for 35.2%, 48.3%, and 27.5% of the videos, respectively.

abstract:
  Objective Surgical education has increasingly relied upon electronic learning, and in particular, online operative videos have become a core resource within the field of neurosurgery. Here, we analyze the current forums for neurosurgical operative videos. Methods Operative videos from 5 sources were reviewed: (1) the NEUROSURGERY Journal YouTube channel; (2) the AANSNeurosurgery YouTube channel; (3) The Neurosurgical Atlas Operative Video Cases; (4) Operative Neurosurgery; and (5) Neurosurgical Focus: Video. Title, year of publication, senior author, institution, country, and subspecialty were documented for each video. Results A total of 1,233 videos demonstrating 1,247 surgeries were identified. Ten videos included >1 surgery; of those, there was a median of 2 surgeries (interquartile range, 2.0–2.5) per video. The most frequently represented subspecialties include vascular (48.3%), tumor (35.2%), and skull base surgery (27.5%), with almost 40% of videos depicting >1 category. Videos were submitted by authors from 28 countries, but 82.1% of the videos originated in the United States. Conclusion Neurosurgical operative videos have become increasingly common through a variety of online platforms. Future efforts may benefit from collecting videos from underrepresented regions and subspecialties, providing long-term follow-up data and demonstrating techniques for managing complications.


id: cord-275784-n6jv72l7
title: The Management Of Neurosurgical Patients During The Covid-19 Pandemic
author: Spina, Alfio
date: 2020-04-30
txt: ./txt/cord-275784-n6jv72l7.txt
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mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020308706
doi: 10.1016/j.wneu.2020.04.161
summary:
  An adequate management protocol can reduce hospital viral spread, improving safety both for patients and healthcare professionals. 1 The management of an ever-increasing number of patients, particularly those suffering from coronavirus disease 2019 (COVID-19) pneumonia has deeply affected the organization of healthcare facilities. 11 In a single-center Chinese case series of 138 hospitalized patients, presumed hospitalrelated infection of COVID-19 was suspected in 41% of patients, with a reported mortality of 4.3% and an intensive care unit admission rate of 26%. 12 Furthermore, COVID-19 transmission rate to healthcare worker was reported up to 20% 13 These data suggest that, inadequate hospital setting may represent a relevant route of SARS-CoV-2 spread both for patients and healthcare professionals. Whenever possible, elective surgery for confirmed cases (i.e. Group 1) should be rescheduled, because of this class of patients show higher risks of intensive care need and death.

abstract:
  ABSTRACT The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is, to date, the major challenge for healthcare systems worldwide. Hospital represents one of main vector amplifying the spread of the disease among both patients and healthcare professionals. Adequate department organization is pivotal to reduce hazards while still ensuring the highest quality of care. In this document we aim to share the recent experience of a Neurosurgery department located in one of the first and largest coronavirus disease 2019 (COVID-19) pandemic epicenters. A review of the available literature was also performed. Case selection, operating room and postoperative management of neurosurgical patients were discussed. COVID-19 pandemic has upset healthcare organizations, requiring a deep reorganization in many respects. An adequate management protocol can reduce hospital viral spread, improving safety both for patients and healthcare professionals.


id: cord-275926-rj23z7po
title: Neurosurgical practice during the SARS-CoV-2 pandemic: a worldwide survey
author: Fontanella, Marco M.
date: 2020-05-05
txt: ./txt/cord-275926-rj23z7po.txt
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mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1878875020309141?v=s5
doi: 10.1016/j.wneu.2020.04.204
summary:
  3. Institutional plans for the SARS-CoV-2 outbreak: any special measures adopted for SARS-CoV-2 positive neurosurgical patients were investigated, i.e. their screening rate and method, any changes in surgical indications, planning and activity for oncologic procedures, non-emergency surgeries, and subarachnoid hemorrhages (SAHs). The same correlation was found with regards to the medical perception of disease activity (Q2) in different countries, and only few respondents (3%) claimed their country was not facing the outbreak during the time period studied: among them, neurosurgeons from Germany were probably the most "wrong", since their country had between 10 4 to 10 5 SARS-CoV2 patients during the study period (Fig. 4A) . 5 India and Pakistan have been reported to be the world''s best respondents to the SARS-COV-2 pandemic, 22-24 thus reflecting high rates of neurosurgical activity reorganizations.

abstract:
  Abstract Background and Objective The SARS-CoV-2 pandemic has consistently changed medical practice throughout specialties, regardless of their contribution in facing the disease itself. We surveyed neurosurgeons worldwide to investigate the situation they are experiencing. Design and participants A 17-question, web-based survey was administered to neurosurgeons worldwide through the WFNS and the Neurosurgery Cocktail from March 28 to April 5, 2020 by web link or e-mail invitation. Questions were divided into three subgroups: general information, health system organization, and institutional plans for the SARS-CoV-2 outbreak. Collected data was initially elaborated using Survey Monkey® software. Country specific data were extracted from the WHO website. Statistical analysis was performed using R version 3.6.3. Results Of the 446 respondents, most were from Italy (20%), India (19%), and Pakistan (5%). Surgical activity was significantly reduced in most centers (79%) and dedicated in-hospital routes were created for SARS-CoV-2 patients (58%). Patient screening was performed only when there were symptoms (57%) and not routinely before surgery (18%). The preferred methods included a nasopharyngeal swab and chest x-ray. Health professionals were rarely screened (20%) and sometimes, even if SARS-CoV-2 positive, were asked to work if asymptomatic (26%). Surgical planning was changed in most institutions (92%), while indications were modified for non-urgent procedures (59%) and remained unchanged for subarachnoid hemorrhages (85%). Conclusions Most neurosurgeons worldwide reported work reorganization and practices that respond to current international guidelines. Differences in practice might be related to the perception of the pandemic and significant differences in the health systems. Sharing data and experiences will be of paramount importance to address the present moment and challenges in the near future.


id: cord-276067-3io0xux2
title: COVID-19 and Neurosurgical Education in Africa: Making lemonade from lemons
author: Kanmounye, Ulrick Sidney
date: 2020-05-21
txt: ./txt/cord-276067-3io0xux2.txt
cache: ./cache/cord-276067-3io0xux2.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020310974
doi: 10.1016/j.wneu.2020.05.126
summary:
  In the face of this new reality, and in order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing which reduces in-person interactions. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents and young Neurosurgeons during and after the COVID-19 pandemic. initiative to advance the education of African residents and young Neurosurgeons during and after the COVID-19 pandemic. African residents and young neurosurgeons are already learning from and about world renowned neurosurgeons via online medical education platforms (3). In order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing which reduces in-person interactions. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents during and after the COVID-19 pandemic. Impact of COVID-19 on neurosurgery resident training and education

abstract:
  Abstract Never in history has the fabric of African Neurosurgery been challenged as it is today with the advent of covid-19. Even the most robust and resilient neurosurgical educational systems in the continent have been brought to their knees with Neurosurgical trainees and young neurosurgeons bearing the brunt. In the face of this new reality, and in order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing which reduces in-person interactions. In some cases, residents have been asked to stay home at least till they are instructed otherwise. This unfortunate event presents an innovative opportunity for neurosurgical education in Africa. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents and young Neurosurgeons during and after the COVID-19 pandemic.


id: cord-276829-c1krlejx
author: José Antonio, Soriano Sánchez
date: 2020-05-07
txt: ./txt/cord-276829-c1krlejx.txt
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url: https://www.sciencedirect.com/science/article/pii/S1878875020309360?v=s5
doi: 10.1016/j.wneu.2020.04.226
summary:
  Abstract Background The COVID-19 pandemic has caused severe economic consequences by local governmental measures to contain the outbreak1 We provide insight on the impact that healthcare restriction has made on neurosurgical activity in Latin Iberoamerica. By using the FLANC as a 53 platform, we aimed to provide an insight on the socioeconomic impact that healthcare 54 restriction has made on Latin Iberomerican neurosurgical practice as a baseline to 55 understand the potential financial burden it will imply (especially to other physicians 56 involved in non-essential treatment) in terms of sustainability if these measures are to be 57 overcome) this crisis. The medical praxis has also been affected, as the World Health Organization has 181 recommended reducing activity with the advance of epidemy in local countries to provide 182 essential care to give the best use of resources to contain the outbreak and reduce infection 183 rates 5 .

title:
  EARLY REPORT ON THE IMPACT OF COVID-19 OUTBREAK IN NEUROSURGICAL PRACTICE AMONG MEMBERS OF THE LATIN AMERICAN FEDERATION OF NEUROSURGICAL SOCIETIES

abstract:
  Abstract Background The COVID-19 pandemic has caused severe economic consequences by local governmental measures to contain the outbreak1 We provide insight on the impact that healthcare restriction has made on neurosurgical activity in Latin Iberoamerica. METHODS: We performed an internet-based survey among Presidents and Members of the Societies of the Latin American Federation of Neurosurgical Societies (FLANC). We blindly analyzed information about local conditions and their impact on neurosurgical praxis using SPSS® software. Results Information came from 21 countries. Sixteen Society Presidents reported having suspended regular activities, and differing local scheduled congresses, fourteen reported mandatory isolation by government, and four instituted a telemedicine project. Four-hundred eighty-six colleagues, mean age 49 years, reported a mean 79% reduction in their neurosurgical praxis. Seventy-six percent of neurosurgeons had savings to self-support for 3-6 months, if restrictions are long lasting. Conclusions Stopping activities among Societies of the FLANC, together with a drop of 79% of neurosurgical praxis, adds to deficits in provider´s protection equipment and increasing demand for attention in the healthcare systems; representing a huge financial risk for their sustainability. Neurosurgeons should involve in local policies to protect health and economy. Telemedicine represents an excellent solution, avoiding another pandemic of severe diseases across all-specialties as non-essential care can turn essential if left untreated. Financial support and ethics code review is needed to battle this new disease, designated the occupational disease of the decade, that continues to struggle the healthcare systems. Times of crisis are times of great opportunities for humanity to evolve.


id: cord-277801-auq3msc6
title: Adapting Neurosurgery Practice During The Covid-19 Pandemic In The Indian Subcontinent
author: Deora, Harsh
date: 2020-07-15
txt: ./txt/cord-277801-auq3msc6.txt
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mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.07.038
doi: 10.1016/j.wneu.2020.07.038
summary:
  Material and Methods An online questionnaire-based survey was prepared, with questions related to the COVID specific themes of precautions taken in outpatient services and operation theaters, the influence of social media, the economic loss incurred, and the perceptible impact of telemedicine and webinars. An online questionnaire-based survey was prepared, with questions related to the COVID specific themes of precautions taken in outpatient services and operation theaters, the influence of social media, the economic loss incurred, and the perceptible impact of telemedicine and webinars. Suspension of elective procedures, severe curtailment of the regular outpatient appointments, drastic modifications of the normal OPD/OR practices and apprehensions related to inadequacy of safety provided by PPE usage and financial losses of private establishments were some of the visible themes in our survey results.

abstract:
  ABSTRACT Background The COVID-19 pandemic has changed the practice of neurosurgery. Significant resources have been dedicated to it. The pandemic in the Indian subcontinent, when compared to the rest of the world, is relatively delayed. The neurosurgical practice cannot remain unaffected by hugely disruptive measures such as a lockdown. The inevitable rise in covid infections with its gradual relaxation continues to pose a risk for health care providers. Therefore, it is imperative to evaluate whether the pandemic has had a discernible effect on the same especially in terms of practice modifications in private establishments and publicly funded hospitals, the emotional impact on the surgeon, and the influence of social media on the psyche of the surgeon. Material and Methods An online questionnaire-based survey was prepared, with questions related to the COVID specific themes of precautions taken in outpatient services and operation theaters, the influence of social media, the economic loss incurred, and the perceptible impact of telemedicine and webinars. The links to the survey were mailed to neurosurgeons in private and public practice all over the country. The responses were anonymized to ensure free and unbiased answers to the survey questions. Results A total of 176 responses were received from all over the Indian Sub-Continent. The median age of respondents was 39years (range 32-70 yrs) and the post-residency experience was 7years (range 0-34 yrs). Respondents were an equitable mix of public and private practitioners. 46% of the respondents were practicing restricted outpatient services, more in public institutions (p=0.22) which also had a higher incidence of tele-outpatient services(26% vs 17%). Wearing surgical masks, N-95 masks, and gloves were the most commonly practised precautionary measures in outpatient services(>60%). While private practitioners were continuing elective cases(40%), public institutes were more cautious with only emergencies being operated(29%). The greatest fear among all practitioners was passing the infection to the family (75%). Social media was helpful for brainstorming queries and updating practice modifications, but some surgeons admitted to receiving threats upon social media platforms(37.5%). Depression and economic losses were palpable for approximately 30% neurosurgeons. Conclusion The survey highlights the perception of the neurosurgeons towards the pandemic and the difference in public-private practice. Suspension of elective procedures, severe curtailment of the regular outpatient appointments, drastic modifications of the normal OPD/OR practices and apprehensions related to inadequacy of safety provided by PPE usage and financial losses of private establishments were some of the visible themes in our survey results. Though telemedicine has not been as widely adopted as expected, yet online education has been favourably received.


id: cord-285226-4ydvjmr3
title: The Future of Skull Base Surgery: A View Through Tinted Glasses
author: Sekhar, Laligam N.
date: 2020-06-27
txt: ./txt/cord-285226-4ydvjmr3.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32599213/
doi: 10.1016/j.wneu.2020.06.172
summary:
  This leads to an examination of recent developments in the field and outlines several promising areas of future improvement in skull base surgery, per se, as well as identifying new hospital support systems needed to accommodate these changes. These include, but are not limited to advances in imaging, Raman Spectroscopy and Microscopy, 3-dimensional printing and rapid prototyping, master-slave and semi-autonomous robots, artificial intelligence applications in all areas of medicine, tele-medicine, and green technologies in hospitals. 44 45 More recent technological introductions have proceeded to revolutionize the 46 treatment of challenging skull base pathology including the introduction of 47 endoscopic surgery, advances in neuroimaging, radiosurgery and high energy 48 focused radiotherapy, the perfection of vascular bypasses for replacement of 49 major arteries and venous sinuses involved by tumors 1,2,3 , and the use of skull 50 base approaches to treat complex vascular lesions. Humanoid robotic nursing assistants 558 will be developed and widely used in future due to health care worker shortages, 559 patients'' desire to have 24x7 nursing assistance, and the needs created by 560 infectious diseases wherein human-human contact must be minimized.

abstract:
  ABSTRACT This article broadly outlines the potential advances in the field of skull base surgery, which may occur in the next 20 years based on many areas of current research in biology and technology. Many of these advances are also broadly applicable to other areas of neurosurgery. We ground our predictions for future developments in an exploration of what patients and surgeons most desire as outcomes for care. This leads to an examination of recent developments in the field and outlines several promising areas of future improvement in skull base surgery, per se, as well as identifying new hospital support systems needed to accommodate these changes. These include, but are not limited to advances in imaging, Raman Spectroscopy and Microscopy, 3-dimensional printing and rapid prototyping, master-slave and semi-autonomous robots, artificial intelligence applications in all areas of medicine, tele-medicine, and green technologies in hospitals. In addition, we review therapeutic approaches employing nanotechnology, genetic engineering and anti-tumoral antibodies, as well as stem cell technologies to repair damage caused by traumatic injuries, tumors, and iatrogenic injuries to the brain and cranial nerves. Additionally, we discuss the training requirements for future skull- base surgeons and stress the need for adaptability and change. However, the essential requirements for skull base surgeons remain unchanged, namely: knowledge, attention to details, technical skill, innovation, judgement, and compassion. Our conclusion is that active involvement in these rapidly evolving technologies will enable us to shape some of the future of our discipline to address the needs of both patients and our profession.


id: cord-287237-fobek8ak
title: Clinical anatomy of the extradural neural axis compartment: a literature review
author: Bond, Jacob D.
date: 2020-07-22
txt: ./txt/cord-287237-fobek8ak.txt
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mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.07.095
doi: 10.1016/j.wneu.2020.07.095
summary:
  This intermediate region of the EDNAC represents an adipose corridor between the meningeal and periorbital dura which transmits the lacrimal and frontal branches of the ophthalmic nerve (CN V 1 ), the trochlear nerve (CN IV), the superior ophthalmic vein as well as fat and orbital veins from the orbit to the lateral sellar compartment. While this compartment possesses a significant mass of fat, and contains a number of neurovascular structures, it is roofed by the orbital muscle of Müller and communicates with the cavernous sinus via the foramen rotundum, but is not considered an anteroinferior extension of the EDNAC. 27 It is highly likely that the hypoglossal canal (transmitting CN XII, the posterior meningeal artery and anterior condylar vein) may also contain an extension of EDNAC seeing that it is immediately adjacent to a significant deposition of fat in the spinal epidural space.

abstract:
  Abstract Objective The extradural neural axis compartment (EDNAC) is an adipovenous zone located between the meningeal and endosteal layers of dura and has been minimally investigated. It runs along the neuraxis from the orbits down to the coccyx and contains fat, valveless veins, arteries and nerves. This review aims to outline the current knowledge regarding the structural and functional significance of the EDNAC. Methods A narrative review of EDNAC literature was conducted. Results The EDNAC can be organised into four regional enlargements along its length. These are the orbital, lateral sellar, clival and spinal segments with a lateral sellar orbital junction linking the orbital and lateral sellar segments. The orbital EDNAC facilitates movement of the eyeball, while elsewhere it allows limited motility for the meningeal dura. Major nerves and vessels are cushioned and supported by the EDNAC. Raised intraabdominal pressure (IAP) is also conveyed along the spinal EDNAC causing increased venous pressure in the spine and cranium. From a pathological perspective, the EDNAC functions as a low-resistance, extradural passageway that might facilitate tumour encroachment and expansion. Conclusions Clinicians should be aware of the extent and significance of the EDNAC which may impact on skull base/spine surgery and present understanding of tumour spread pathways and growth patterns. Comparatively little research has focussed on the EDNAC since its initial description therefore future investigations will provide more information on this underappreciated component of neuraxial anatomy.


id: cord-289111-6725jg29
title: Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt
author: Field, Nicholas C.
date: 2020-06-25
txt: ./txt/cord-289111-6725jg29.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32592966/
doi: 10.1016/j.wneu.2020.06.141
abstract: nan
summary:
  In order to demonstrate the degree of change, we wish to report the dramatic decrease in operative, outpatient clinic, and consult volume at our institution, Albany Medical Center, an Academic Level 1 Trauma Center in upstate New York. 2 We rapidly trialed and implemented a video conference telehealth system by the end of March and have seen a dramatic shift in our clinic practice while continuing to provide appropriate patient care ( Figure 1 ). Our resident service was split into an on-call and backup team due to the decrease in case volume, and also to limit exposure to COVID-19, and provide coverage in the Neuro ICU. Our program has seen a significant reduction in consults and operations over the past three months despite being in a region with a linear case rise that has not been overwhelmed by the pandemic. The COVID-19 pandemic has led to a dramatic decline in elective neurosurgical procedures, consults, and clinic visits.


id: cord-292429-28mwv9f7
title: Incorporating telehealth to improve neurosurgical training during the COVID-19 pandemic
author: Miranda, Stephen P.
date: 2020-05-17
txt: ./txt/cord-292429-28mwv9f7.txt
cache: ./cache/cord-292429-28mwv9f7.txt
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mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020310871
doi: 10.1016/j.wneu.2020.05.116
summary:
  At our institution, we have found that involving residents in telehealth clinic and supplementing this time with virtual, case-based conferences have already enhanced resident education, by taking learning models classically used in surgical skills training and applying them to surgical decision-making and management instead. Nevertheless, outpatient clinical experience provides a critical opportunity for trainees to develop the non-operative skills emphasized by the ACGME Milestones, including information gathering and interpretation, evidence-based practice, critical thinking for diagnosis and therapy, and awareness of healthcare systems (Table 1) . Residents have the autonomy to conduct clinical encounters and deliberately practice their approach (Ericsson''s theory, mastery learning model). Prior to COVID-19, at our weekly case conference with all residents and faculty present, patients from each clinical site are presented and residents have the opportunity to simulate an oral boards examination, practicing surgical decision-making with each case scenario.

abstract:
  • Telehealth clinic provides learning for residents. • Resident education achievable during COVID-19. • Learning model adaptable based on local viral burden.


id: cord-293166-gkzebyda
author: Hoz, Samer S.
date: 2020-11-03
txt: ./txt/cord-293166-gkzebyda.txt
cache: ./cache/cord-293166-gkzebyda.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020318271
doi: 10.1016/j.wneu.2020.08.060
abstract: nan
summary:
  title: Letter to the Editor: "Beyond Containment: Tracking the Impact of Coronavirus Disease 2019 (COVID-19) on Neurosurgery Services in Iraq" Letter to the Editor: "Beyond Containment: Tracking the Impact of Coronavirus Disease 2019 (COVID-19) on Neurosurgery Services in Iraq" LETTER: The Neurosurgery Teaching Hospital (NTH) in Baghdad, Iraq, provides neurosurgical care for 4.2 million people-approximately 50% of the population in Baghdad, with a total capacity of 102 beds, 16 neurosurgical intensive care unit (NICU) beds, and 7 operating rooms. Cases requiring less immediate care are only admitted if the condition is deemed to be "urgent." This decision is the responsibility of a newly assembled local hospital committee, composed of 3 senior neurosurgeons. As for patients, a total of 25 acute trauma cases have been confirmed to be positive by immediate postoperative polymerase chain reaction. Such situations are hazardous and require urgent legislative change that determines the COVID-19 status of all admitted patients to be positive unless proven otherwise.

title:
  Letter to the Editor: “Beyond Containment: Tracking the Impact of Coronavirus Disease 2019 (COVID-19) on Neurosurgery Services in Iraq”


id: cord-295029-zki5ac2g
author: Pena, Robert C.F.
date: 2020-11-03
txt: ./txt/cord-295029-zki5ac2g.txt
cache: ./cache/cord-295029-zki5ac2g.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020318854
doi: 10.1016/j.wneu.2020.08.116
abstract: nan
summary:
  1 This simple, cost-effective method can be easily assembled and is flexible with minimal disruption of the surgery being performed, while offering the ability to shield essential personnel in the operating room during procedures involving drilling of air-cells potentially harboring SARS-CoV-2 virions. 1,10 This draping method may therefore provide additional protection to surgeons against multiple viruses aerosolized by a wide range of drill settings, although further research should be conducted regarding COVID-19 aerosol generation in relation to drill speed in neurosurgical and otolaryngology-based procedures. Finally, whereas other researchers have proposed various methods of mask modification or alternate materials to provide barrier protection against COVID-19 aerosol transmission, 9 this and prior draping techniques may offer additional simple, easy to assemble, and cost-effective intraoperative protection. Specifically, this method provides protection to neurosurgical staff during high-speed drilling in the posterior fossa, whereas previously described drapes focus more on the restricted dissemination of COVID-19-laden aerosols during intubation, extubation, positive pressure ventilation, and endonasal endoscopic procedures.

title:
  In Reply to the Letter to the Editor Regarding “Coronavirus Neurosurgical/Head and Neck Drape to Prevent Aerosolization of Coronavirus Disease 2019 (COVID-19): The Lenox Hill Hospital/Northwell Health Solution”


id: cord-303000-tmk2c9eh
author: Alhaj, Ahmad Kh.
date: 2020-05-16
txt: ./txt/cord-303000-tmk2c9eh.txt
cache: ./cache/cord-303000-tmk2c9eh.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020310585
doi: 10.1016/j.wneu.2020.05.087
summary:
  The aim is to identify the level of knowledge, readiness, and the impact of this virus among neurosurgery residents in different programs. To our best knowledge, this is the first study regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and the impact it has on their training. The aim of this study is to identify the level of knowledge, readiness, practices, as well as the impact of this virus among neurosurgery residents in various neurosurgical programs. The final section (6 items) focuses on the impact of this pandemic on the resident in terms of neurosurgical training, studying, mental health, as well as whether their social life was affected or not. Table 3 demonstrates the association of this score about the virus with gender, age, year of residency training, location of the neurosurgery program. Our study is the first regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and the impact it has on their training.

title:
  Neurosurgery Residents Perspective on the COVID-19: Knowledge, Readiness, and Impact of this Pandemic.

abstract:
  Abstract Background The novel Coronavirus disease (COVID-19) is a life-threatening illness, which represents a challenge to all the health-care workers. Neurosurgeons around the world are being affected in different ways. Objectives This is the first study regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and its impact. The aim is to identify the level of knowledge, readiness, and the impact of this virus among neurosurgery residents in different programs. Methods A cross-sectional analysis in which 52 neurosurgery residents from different centers were selected to complete a questionnaire-based survey. The questionnaire comprised of three sections and 27 questions that ranged from knowledge to impact of the current pandemic on various features. Results The median knowledge score was 4 out of 5. The proportion of participants with satisfactory knowledge level was 60%. There was a statistically significant difference between the knowledge score and location of the program. Around 48% of the neurosurgery residents dealt directly with COVID-19 patients. Receiving a session about personal protective equipment (PPE) was reported by 57.7%. The neurosurgery training at the hospital was affected. About 90% believed that this pandemic influenced their mental health. Conclusion Neurosurgery residents have a relatively good knowledge about COVID-19. The location of the program was associated with knowledge level. Most of the participants did not receive a sufficient training about PPE. Almost all responders agree that their training at the hospital was affected. Further studies are needed to study the impact of this pandemic on neurosurgery residents.


id: cord-307013-80dup4sr
author: Lu, Victor M.
date: 2020-08-24
txt: ./txt/cord-307013-80dup4sr.txt
cache: ./cache/cord-307013-80dup4sr.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1878875020314704
doi: 10.1016/j.wneu.2020.06.202
abstract: nan
summary:
  title: Letter to the Editor: Lessons to Learn from the Coronavirus Disease 2019 (COVID-19) Pandemic for International Medical Graduate Applicants and United States Neurosurgery Residency Programs In light of the current COVID-19 pandemic, a number of changes affecting the visa process in the United States has revealed particular immigration policies that are subject to change without notice. Therefore, being present in the United States before Match Day is recommended to ensure that if an IMG candidate is successful, changes in travel policies and plans will not impact their ability to start residency on time. As lockdowns in the United States began, the U.S. Citizenship and Immigration Services suspended premium processing of H1-B visas, 5 which would have greatly impacted incoming IMG residents. The current COVID-19 pandemic has shed light on how difficult the immigration process can be for prospective IMG applicants and U.S. neurosurgery programs, as well as how unpredictable it can be.

title:
  Letter to the Editor: Lessons to Learn from the Coronavirus Disease 2019 (COVID-19) Pandemic for International Medical Graduate Applicants and United States Neurosurgery Residency Programs


id: cord-310144-s25do8cb
author: Lara-Reyna, Jacques
date: 2020-07-27
txt: ./txt/cord-310144-s25do8cb.txt
cache: ./cache/cord-310144-s25do8cb.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.07.155
doi: 10.1016/j.wneu.2020.07.155
summary:
  In an attempt to slow the progression of COVID-19 pandemic, New York state and city governments enacted strict social distancing policies starting on March 12th, which included a progressive restriction and cancellation of non-fundamental activities, like the closure of schools, restaurants, bars, and business; as well as the cancellation of all elective surgical procedures. To assess these possible changes, we reviewed all neurotrauma admissions to our trauma center during the early COVID-19 period, and assessed changes in frequency, demographics, and mechanisms, in order to highlight any changes due to social distancing policies. 8 During this time period, we observed a decrease in the frequency of neurotrauma at the early phase after the strict limitation of non-essential activities in the city, compared to the pre-COVID-19 period. Interestingly, transit-related neurotrauma, as well as TBIs related to violence (direct head trauma with an object) increased in frequency in the COVID-19 period showing significant difference.

title:
  “Staying Home” - Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic

abstract:
  ABSTRACT Objective New York City is the epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic in the United States. Traumatic brain injury accounts for a significant proportion of admissions to our trauma center. We sought to characterize the effect of the pandemic on neurotraumas, given the cancellation of non-essential activities during the crisis. Methods Retrospective and prospective review were performed from November 2019 to April 2020. General demographics, clinical status, mechanism of trauma, diagnosis, and treatment instituted were recorded. We dichotomized the data between pre-COVID-19 (before March 1st) and COVID-19 periods and compared the differences between the two groups. We present the timeline of events since the beginning of crisis in relation to the number of neurotraumas. Results A total of 150 patients composed our cohort with a mean age of 66.2 years (SD+/-: 18.9), and 66% male. More males sustained neurotrauma in the COVID-19 period compared with the pre-COVID-19 (60.4% vs 77.6%, p=0.03). The most common mechanism of trauma was mechanical fall, but it was observed less frequently compared to the pre-COVID-19 period (61.4% vs 40.8; p=0.03). Subdural hematoma, traumatic subarachnoid hemorrhage, and intracerebral contusion accounted for the most common pathologies in both periods. Non-operative management was selected for most patients (79.2 vs 87.8%, p= 0.201) in both periods. Conclusions A decrease in the frequency of neurotraumas was observed during the COVID-19 crisis concomitant with the increase in COVID-19 patients in the city. This trend began after the cancellation of non-essential activities and the implementation of social distancing recommendations.


id: cord-310288-onr700ue
author: Sciubba, Daniel M.
date: 2020-05-29
txt: ./txt/cord-310288-onr700ue.txt
cache: ./cache/cord-310288-onr700ue.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020312043
doi: 10.1016/j.wneu.2020.05.233
summary:
  title: Scoring system to triage patients for spine surgery in the setting of limited resources: Application to the COVID-19 pandemic and beyond Methods Using a modified Delphi technique, a cohort of 16 fellowship-trained spine surgeons from 10 academic medical centers constructed a scoring system for the triage and prioritization of emergent and elective spine surgeries. Results The devised scoring system included 8 independent components: neurological status, underlying spine stability, presentation of a high-risk post-operative complication, patient medical comorbidities, expected hospital course, expected discharge disposition, facility resource limitations, and local disease burden. Conclusion Here we present the first quantitative urgency scoring system for the triage and prioritizing of spine surgery cases in resource-limited settings. The devised scoring system included 8 independent components: neurological status, underlying 19 spine stability, presentation of a high-risk post-operative complication, patient medical 20 comorbidities, expected hospital course, expected discharge disposition, facility resource 21 limitations, and local disease burden.

title:
  Scoring system to triage patients for spine surgery in the setting of limited resources: Application to the COVID-19 pandemic and beyond

abstract:
  Abstract Background As of May 04, 2020, the COVID-19 pandemic has affected over 3.5 million people and touched every inhabited continent. Accordingly, it has stressed health systems the world over leading to the cancellation of elective surgical cases and discussions regarding healthcare resource rationing. It is expected that rationing of surgical resources will continue even after the pandemic peak, and may recur with future pandemics, creating a need for a means of triaging emergent and elective spine surgery patients. Methods Using a modified Delphi technique, a cohort of 16 fellowship-trained spine surgeons from 10 academic medical centers constructed a scoring system for the triage and prioritization of emergent and elective spine surgeries. Three separate rounds of videoconferencing and written correspondence were used to reach a final scoring system. Sixteen test cases were used to optimize the scoring system so that it could categorize cases as requiring emergent, urgent, high-priority elective, or low-priority elective scheduling. Results The devised scoring system included 8 independent components: neurological status, underlying spine stability, presentation of a high-risk post-operative complication, patient medical comorbidities, expected hospital course, expected discharge disposition, facility resource limitations, and local disease burden. The resultant calculator was deployed as a freely-available web-based calculator (https://jhuspine3.shinyapps.io/SpineUrgencyCalculator/). Conclusion Here we present the first quantitative urgency scoring system for the triage and prioritizing of spine surgery cases in resource-limited settings. We believe that our scoring system, while not all-encompassing, has potential value as a guide for triaging spine surgical cases during the COVID pandemic and post-COVID period.


id: cord-311588-ocz2rzy7
title: Collateral Damage During the COVID-19 Pandemic
author: Gilligan, Jeffrey
date: 2020-05-14
txt: ./txt/cord-311588-ocz2rzy7.txt
cache: ./cache/cord-311588-ocz2rzy7.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32419877/
doi: 10.1016/j.wneu.2020.05.091
abstract: nan
summary:
  At our institution, similarly, we have seen both a huge decline in patients seeking care for neurological and neurosurgical diagnoses, as well as late presentation of life-threatening conditions. She refused to seek care at the hospital due specifically to fear of contracting COVID-19. What remains unknown is how many patients with known or unknown pathologies are having progression of a deficit (i.e. worsening vision secondary to a supersellar mass or worsening cervical myelopathy) that would otherwise have brought them to seek urgent medical care. In our own institution, resources and staff are finally being able to assist with non-COVID patient duties. The untold toll -The pandemic''s effects on patients without COVID-19 As the pandemic subsides, we will need to ask our leaders, public health officials, and the media to send a message to patients at risk: please seek help if you''re not well or having worsening symptoms.


id: cord-312345-gn6mwun0
title: Letter to the Editor: COVID-19 & Neurosurgical Training in Low- and Middle-Income Countries
author: Kanmounye, Ulrick Sidney
date: 2020-09-23
txt: ./txt/cord-312345-gn6mwun0.txt
cache: ./cache/cord-312345-gn6mwun0.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.07.018
doi: 10.1016/j.wneu.2020.07.018
abstract: nan
summary:
  Letter to the Editor: COVID-19 & Neurosurgical Training in Low-and Middle-Income Countries O n June 11, 2020, the World Federation of Neurosurgical Societies (WFNS)'' Global Neurosurgery Committee (GNC) and Young Neurosurgeons Forum (YNF) discussed the effects of coronavirus disease 2019 (COVID-19) on training in low-and middle-income countries (LMICs). During this event, the leadership of the WFNS and stakeholders of global neurosurgery identified challenges and proposed solutions to the issues faced by trainees during the pandemic. Although the current COVID-19 pandemic has had a sudden and negative effect on the ability to train neurosurgeons, especially in LMICs, the increased use of social media and virtual platforms (in our case, Zoom) is markedly improving the interactions between the leadership of the WFNS and neurosurgeons around the globe.


id: cord-313503-wvgwf9n3
author: D’Amico, Randy S.
date: 2020-07-23
txt: ./txt/cord-313503-wvgwf9n3.txt
cache: ./cache/cord-313503-wvgwf9n3.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020316545
doi: 10.1016/j.wneu.2020.07.133
abstract: nan
summary:
  title: Neurosurgical/Head and Neck drape to Prevent Aerosolization of COVID-19 The Lenox Hill Hospital/Northwell Health solution. Although COVID-19 screening and testing guidelines have been proposed and adopted by many hospitals, these may not adequately protect the operating room personnel who are in proximity to the patient for prolonged periods. There are concerning reports of especially high transmission rates of COVID-19 in trans-mucosal head and neck procedures conducted by otolaryngologists and neurosurgeons, despite attempts at wearing what constitutes appropriate PPE. 3 Here we describe the simple intraoperative technique we utilize at Lenox Hill Hospital/Northwell Health for all cranial, endonasal, spinal, and neuro-interventional cases to limit the intraoperative transmission COVID-19 to essential staff in the operating rooms and the endovascular suite who are at a substantially higher risk of exposure to the disease.

title:
  Neurosurgical/Head and Neck drape to Prevent Aerosolization of COVID-19 - The Lenox Hill Hospital/Northwell Health solution.


id: cord-317965-pini4eqw
title: Virtual Residency Training Interviews in the Age of COVID-19 and Beyond
author: Al Saiegh, Fadi
date: 2020-10-06
txt: ./txt/cord-317965-pini4eqw.txt
cache: ./cache/cord-317965-pini4eqw.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1878875020319136
doi: 10.1016/j.wneu.2020.08.144
abstract: nan
summary:
  Because this is not a practice the medical community is accustomed to, we simulated virtual residency training interviews and compared 2 models to assess the feasibility and uncover the technical challenges in preparation for the upcoming interview season. Using 5 interviewers and 10 interviewees consisting of senior neurosurgery residents and fourth-year medical students, respectively, we authors devised 2 models using the Zoom platform (Zoom Inc., San Jose, California, USA) to simulate the interviews ( Figure 1 ). The "static model" followed the traditional on-site interview structure, in which the interviewees rotate through several rooms meeting with different interviewers for w10 minutes each. The goal of our simulation was to find a model that would give applicants the most natural feel and allowing interviewers an adequate opportunity to assess their prospective residents. They reported that the dynamic model provided smoother transitions, allowed the applicants to be more comfortable, and gave participants a more natural feel.


id: cord-318897-7bq0nhwm
title: Impact of COVID-19 outbreak on acute low back pain
author: Borsa, Stefano
date: 2020-05-29
txt: ./txt/cord-318897-7bq0nhwm.txt
cache: ./cache/cord-318897-7bq0nhwm.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S187887502031189X
doi: 10.1016/j.wneu.2020.05.218
abstract: nan
summary:
  We would like to bring our contribution from one of the most affected regions of the world by the SARS-CoV-2 on how pandemic has influenced the number of visits for low back pain and to provide food for thought for a reorganization of low back pain management in the post-COVID-19 era. We collected data from 4 hospitals in Milan on Emergency Ward (EW) and on Outpatient Department (OD) visits for acute low back pain (ALBP) for the period March 8 th , 2020 -April 8 th , 2020 and for the same period of the previous year. Last month 103 patients came for ALBP, 73 in the EWs and 30 in the ODs. In the EWs 45 patients had LBP, 22 presented sciatica, 5 had fractures (porotics) and 1 a tumor (prostate cancer). In the ODs 52 patients had LBP, 89 presented sciatica, 8 had fractures (porotics) and 6 tumors (2 breast cancers, 3 prostate cancers and 1 colorectal cancer).


id: cord-319268-mqxwwwcd
author: Raj, Sumit
date: 2020-11-03
txt: ./txt/cord-319268-mqxwwwcd.txt
cache: ./cache/cord-319268-mqxwwwcd.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33167155/
doi: 10.1016/j.wneu.2020.08.117
abstract: nan
summary:
  title: Letter to the Editor Regarding: "Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC" Letter to the Editor Regarding: "Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC" W e read the article by Dowlati et al., 1 in which the authors shared their thought-provoking observations to determine the risk of a neurosurgical patient becoming infected with coronavirus disease 2019 in the perioperative period and the effect of COVID-19 on the neurosurgical case volumes. The results and findings from their study have shown that a real risk of perioperative transmission exists and have summarized how the current COVID-19 pandemic has been changing the neurosurgical caseload patterns. Case volumes and perioperative COVID-19 incidence in neurosurgical patients during a pandemic: experiences at two tertiary care centers in

title:
  Letter to the Editor Regarding: “Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC”


id: cord-320065-zxh8u4eg
title: Tracking the Volume of Neurosurgical Care during the COVID-19 Pandemic
author: Patel, Pious D.
date: 2020-06-27
txt: ./txt/cord-320065-zxh8u4eg.txt
cache: ./cache/cord-320065-zxh8u4eg.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.06.176
doi: 10.1016/j.wneu.2020.06.176
summary:
  Abstract Objective This study quantifies the impact of COVID-19 on the volume of adult and pediatric neurosurgical procedures, inpatient consults, and clinic visits at an academic medical center. This was the 776 week time period immediately following the signing of a Tennessee gubernatorial executive 77 order preventing "non-essential procedures." 9 Patient records from an analogous 7-week period 78 from March 25, 2019 through May 10, 2019 were collected and categorized as "before COVID-79 19." In addition to these time periods, data were collected from the 59 week period spanning Hydrocephalus was defined as ventriculoperitoneal shunt insertion or revision or endoscopic 140 third ventriculostomy. The COVID-19 pandemic led to significant, measurable decreases in neurosurgical caseload, 392 inpatient consults, and outpatient clinic visits. As elective 396 procedures and in-person clinical encounters resume, the effects of reduced volume during 397 COVID-19 on long-term patient outcomes warrants further investigation.

abstract:
  Abstract Objective This study quantifies the impact of COVID-19 on the volume of adult and pediatric neurosurgical procedures, inpatient consults, and clinic visits at an academic medical center. Methods Neurosurgical procedures, inpatient consults, and outpatient appointments at Vanderbilt University Medical Center were identified in the time periods of March 23, 2020 through May 8, 2020 ("During COVID-19") and March 25, 2019 through May 10, 2019 ("Before COVID-19"). Neurosurgical volume was compared between these periods. Results A 40% reduction in weekly procedural volume was demonstrated during COVID-19 (median 75 [IQR 72-80] to 45 [43-47], p<0.001). There was a 42% reduction for weekly adult procedures (62 [54-70] to 36 [34-39], p<0.001), and 31% reduction for weekly pediatric procedures (13 [12-14] to 9 [8-10], p=0.004). Among adult procedures, the most significant decreases were seen for spine (p<0.001), endovascular (p<0.001), and cranioplasty (p<0.001). There was not a significant change for adult open vascular (p=0.291), functional (p=0.263), cranial tumor (p=0.143), or hydrocephalus (p=0.173) procedural volume. Weekly inpatient consults to neurosurgery decreased by 24% (99 [94-114] to 75 [68-84], p=0.008) for adults. Weekly in-person adult and pediatric outpatient clinic visits witnessed a 91% decrease (329 [326-374] to 29 [26-39], p<0.001). Weekly telehealth encounters increased from 0 [0-0] to 151 [126-156] (p<0.001). Conclusion There were significant reductions in neurosurgical operations, clinic visits, and inpatient consults during COVID-19. Telehealth was increasingly used for assessment. The long-term impacts of reduced neurosurgical volume and increased telehealth utilization on patient outcomes should be explored.


id: cord-320991-nkkmzymu
author: Cabrera, Juan P.
date: 2020-05-18
txt: ./txt/cord-320991-nkkmzymu.txt
cache: ./cache/cord-320991-nkkmzymu.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1878875020309517
doi: 10.1016/j.wneu.2020.05.003
abstract: nan
summary:
  Before SARS-CoV-2 arrived in Latin America, the ideal timing for surgical treatment of spine trauma cases was highly influenced by local conditions with great heterogeneity, including differences in access to health care between public and private systems. When these patients present with spine trauma, there is no knowledge regarding SARS-CoV-2 status, including in low-risk or asymptomatic patients, thereby impacting the final outcome if the patient treated has COVID-19, 8 and sometimes the surgery is already performed, having the potential to spread the infection to health care workers. A potential side effect of the COVID-19 pandemic for patients with spinal trauma is a delay in surgical treatment in patients with less severe injuries, who may develop late deformities or neurologic deterioration, owing to limited health care resources.

title:
  Letter to the Editor: Is COVID-19 the Cause of Delayed Surgical Treatment of Spine Trauma in Latin America?


id: cord-322052-zsbisk3b
author: Bohórquez-Rivero, José
date: 2020-08-24
txt: ./txt/cord-322052-zsbisk3b.txt
cache: ./cache/cord-322052-zsbisk3b.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.06.142
doi: 10.1016/j.wneu.2020.06.142
abstract: nan
summary:
  Challenges neurosurgeons are facing include, among others, the advent of new technologies, an increasingly impersonal physician-patient relationship, loss of interest in the emotional aspects of the patient, differences in public versus private care, loss of autonomy to make decisions about patients, loss of interest in performing an adequate physical examination, and hospitals becoming increasingly less humanized. As a result, in daily neurosurgical practice and during the process of training new neurosurgeons, humanistic principles receive little attention, and scientific and technical aspects dominate. 3 Therefore, the humanization of the neurosurgeon must begin from the first years of residency, medical school, and even high school, as the development of the ability to communicate and interact with patients and their family members requires time and preparation. Moreover, neurosurgical centers should advocate for the design of models of humanization, including an environment for neurosurgeons, patients, and families that allows informal physician-patient contacts not related to the disease (e.g., conversations on current topics, humanistic use of patient consciousness, and spheres of subconsciousness).

title:
  Letter to the Editor: Humanization of Neurosurgery: Incorporation of a New Concept in Times of COVID-19


id: cord-322277-mbe9dt3v
title: COVID 19-Depression and Neurosurgeons
author: Sharif, Salman
date: 2020-06-06
txt: ./txt/cord-322277-mbe9dt3v.txt
cache: ./cache/cord-322277-mbe9dt3v.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1878875020312638?v=s5
doi: 10.1016/j.wneu.2020.06.007
abstract: nan
summary:
  The rapid increase in cases and evolving guidelines regarding protection and prevention of the spread of pandemic, with no confirmed treatment or approved vaccine has caused apprehension and anxiety among health care workers. The goal of this survey was to determine the prevalence and factors associated with anxiety and depression among neurosurgeons during the COVID-19 pandemic. Although, a recent Chinese study reported a much higher prevalence of depression (50.4%), anxiety (44.6%) and insomnia (34%) among frontline health care workers. Therefore a feeling of self-protection with provided PPE had a significant negative association with anxiety/depression while a positive COVID colleague increased the likelihood of depression among neurosurgeons. To our knowledge, this is the first study ever to determine the frequency and factors associated with anxiety and depression among 375 neurosurgeons from 52 countries. The prevalence of depression and anxiety among neurosurgeons was found to be lower than the frequency reported among other frontline workers during the COVID pandemic.


id: cord-322497-hdy3va8e
author: LUBANSU, Alphonse
date: 2020-09-03
txt: ./txt/cord-322497-hdy3va8e.txt
cache: ./cache/cord-322497-hdy3va8e.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.08.168
doi: 10.1016/j.wneu.2020.08.168
summary:
  title: COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center. limited clinical neurosurgical experience including COVID-19 patients have been reported. A cohort of all neurosurgical patients managed during the lockdown period is presented and analyzed assessing suspected nosocomial infection risk factors. 69 Patients initially admitted to the neurosurgical ward were less likely to be suspected for a 70 COVID-19 infection when compared to patients admitted for critical emergencies, 71 particularly with neurovascular and stroke-related pathologies. 69 Patients initially admitted to the neurosurgical ward were less likely to be suspected for a 70 COVID-19 infection when compared to patients admitted for critical emergencies, 71 particularly with neurovascular and stroke-related pathologies. Accordingly, the health ministry guidelines reserved biochemical tests of nasopharyngeal 103 samples only for suspected COVID-19 patients requiring hospital admission, and no targeted 104 screening strategy was defined for healthcare providers. The management of emergency spinal surgery 372 during the COVID-19 pandemic in Italy

title:
  COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center.

abstract:
  Introduction The Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge. Different models of reorganization have been described aiming to preserve resources while ensuring optimal medical care. limited clinical neurosurgical experience including COVID-19 patients have been reported. We share organizational experience, attitudes, and preliminary data of patients treated at our institution. Methods Institutional guidelines and patient workflow are described and visualized. A cohort of all neurosurgical patients managed during the lockdown period is presented and analyzed assessing suspected nosocomial infection risk factors. A comparative surgical subcohort from the previous year was used to investigate the impact on surgical activity. Results A total of 176 patients were admitted in 66 days, twenty tested positive for COVID-19. Patients initially admitted to the neurosurgical ward were less likely to be suspected for a COVID-19 infection when compared to patients admitted for critical emergencies, particularly with neurovascular and stroke-related pathologies. The mortality rate of COVID-19 patients was remarkably high (45%), and even higher in patients that underwent surgical intervention (77 %). In addition to the expected drop in surgical activity (-53%), a decrease in traumatic emergencies was noted. Conclusion By applying infection prevention and resource-sparing logistics measures shared by the international medical community, we were able to maintain essential neurosurgical care in a pandemic with controlled nosocomial infection risk. Special consideration should be given to medical management and surgical indications in patients infected with the SARS-CoV-2 virus, as they seem to exhibit a problematic hemostatic profile that might result in an unfavorable clinical and surgical outcome.


id: cord-324719-gecu1ksa
author: Rahman, Md Moshiur
date: 2020-08-24
txt: ./txt/cord-324719-gecu1ksa.txt
cache: ./cache/cord-324719-gecu1ksa.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32871738/
doi: 10.1016/j.wneu.2020.06.225
abstract: nan
summary:
  title: Letter to the Editor: Pain Management Strategy in Neurosurgical Patients During the Coronavirus Pandemic Not only neurosurgeons, but also various specialists, provide both invasive or noninvasive methods to control or relieve pain. It plays a significant role in the patients who do not respond to conservative methods of pain management. Neurosurgeons need to anticipate that because the coronavirus disease 2019 pandemic continues growing, the increasing literature will also attempt to characterize the neurologic manifestations. 4, 5 Because many of the nonurgent neurosurgical procedures have been deferred during this pandemic, there is a need to develop guidelines for the management of painful syndromes (these conditions may not be life-threatening but can be quite disabling). Evidence suggesting the relative efficacy of several therapeutic alternatives might be pretty helpful for patients with disabling pain. Intravenous acetaminophen (paracetamol) for postcraniotomy pain: systematic review and meta-analysis of randomized controlled trials Non-drug non-invasive treatment in the management of low back pain

title:
  Letter to the Editor: Pain Management Strategy in Neurosurgical Patients During the Coronavirus Pandemic


id: cord-325649-zzhsrytw
author: Rispoli, Rossella
date: 2020-08-07
txt: ./txt/cord-325649-zzhsrytw.txt
cache: ./cache/cord-325649-zzhsrytw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32777401/
doi: 10.1016/j.wneu.2020.08.001
summary:
  By the time of the World Health Organization (WHO) classification of the novel coronavirus as a global pandemic (1) , many hospitals in northern Italy were already overcrowded by COVID-19 patients, especially intensive care units, where about 50% of all available ICU beds were occupied by COVID-19 patients ( 2 ) . These include postponing elective surgical procedures until a more appropriate time, putting in place strategies to ensure urgent/emergency operations during the pandemic, defining type of hospital and the assistance pathways, designating COVID-19 operating rooms for urgent procedures with guidance information posted conspicuously to all the professionals, ensuring systematic and correct use of appropriate PPE, controlling and limiting the number of patients'' visitors, developing support strategies for healthcare professionals, and treating outpatients through telemedicine (teleorientation, telemonitoring, and teleinterconsultation) (5) .

title:
  Spine surgery in Italy in the COVID-19 era: Proposal for assessing and responding to the regional state of emergency

abstract:
  Abstract In December 2019, coronavirus disease 2019 (COVID-19) was discovered in Wuhan, Hubei province, from where it spread rapidly across the globe. COVID-19 characteristics – elevated infectivity, rapid spread, and general population susceptibility – pose a great challenge to hospitals. Infectious disease, pulmonology, and intensive care units have been strengthened and expanded. All other specialties have been compelled to suspend or reduce clinical and elective surgical activities. The profound effects on spine surgery call for systematic approaches to optimizing the diagnosis and treatment of spinal diseases. Here, based on the experience of one Italian region, we draw an archetype for assessing the current and predicted level of stress in the health care system, with the aim of enabling hospitals to make better decisions during the pandemic. Further, we provide a framework that may help guide strategies for adapting surgical spine care to the conditions of epidemic surge.


id: cord-326089-8234mcdk
author: Sweid, Ahmad
date: 2020-06-13
txt: ./txt/cord-326089-8234mcdk.txt
cache: ./cache/cord-326089-8234mcdk.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32544621/
doi: 10.1016/j.wneu.2020.06.053
abstract: nan
summary:
  title: Incidence of Acute Ischemic Stroke and Rate of Mechanical Thrombectomy During the COVID-19 Pandemic in a Large Tertiary Care Telemedicine Network The precipitous decrease in AIS admissions and telestroke consults may be a consequence of patients not reporting neurological manifestations due to the fear of contracting the virus by visiting the Emergency Room. Such outcomes are consistent with previous reports by the World Stroke Organization (50%-70% decline in AIS admission) and the cardiology experience from the USA (38% decrease in cardiac catheterization lab STEMI activations). 1, 2 The higher incidence of COVID-19 patients in the overall stroke group can be supported by recent theories that systemic COVID-19 may contribute to a hyper-thrombotic state and increase the risk of AIS. Of the 6 COVID-19 patients, 4 had tandem occlusions or multiple arterial occlusions (67%) compared to historic controls in our stroke series of 15%. Stroke care and the COVID19 pandemic words from our President.

title:
  Incidence of Acute Ischemic Stroke and Rate of Mechanical Thrombectomy During the COVID-19 Pandemic in a Large Tertiary Care Telemedicine Network


id: cord-328869-2qmgjdc1
author: Goyal, Anshit
date: 2020-06-10
txt: ./txt/cord-328869-2qmgjdc1.txt
cache: ./cache/cord-328869-2qmgjdc1.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020312869
doi: 10.1016/j.wneu.2020.06.028
abstract: nan
summary:
  1 However, a few weeks following this directive, multiple state administrations lifted the embargo on elective procedures after ongoing evaluation of case numbers and considering the potential adverse impact of persistent cancellation on other non-COVID patients and financial risk to hospitals. To understand how different academic neurosurgery departments across the US responded to this devastating COVID19 pandemic, we conducted a national survey of program leaders to determine the measures taken for ensuring patient and personnel safety and adapting to teaching and research needs. Certainly, there are limitations to this survey given the low response rate (~20%).While most departments pursued important policies such as cancellation of non-urgent surgeries and performed COVID testing preoperatively, we did find a small number of respondents who reported not offering preoperative testing routinely.

title:
  Survey of Academic US Programs Regarding the Impact of the COVID-19 Pandemic on Clinical Practice, Education and Research in Neurosurgery


id: cord-329704-vnazexhj
title: An Evaluation of Neurosurgical Practices During the COVID-19 Pandemic
author: Pelargos, Panayiotis E.
date: 2020-10-13
txt: ./txt/cord-329704-vnazexhj.txt
cache: ./cache/cord-329704-vnazexhj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33065352/
doi: 10.1016/j.wneu.2020.10.025
summary:
  Methods A survey consisting of twenty-two questions assessing respondent''s operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic as compared to their colleagues. Neurosurgeons in practice less than 20 163 years were significantly more likely to be willing to provide non-neurosurgical care to COVID-164 19 patients than those in practice greater than 20 years (73.1% vs. Overall, nearly three-fourths of neurosurgeons experienced greater than 50% decline in 216 outpatient clinic volume with just over 5% of respondents closing their outpatient clinics during 217 the pandemic.

abstract:
  Objective To understand how the COVID-19 pandemic has affected the neurosurgical workforce. Methods A survey consisting of twenty-two questions assessing respondent’s operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. Results There were 457 respondents throughout the United States and Puerto Rico representing all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost half (49.1%) of respondents had to downsize their practice staff, office assistants, nurses, schedulers, etc. Overall, 43.6% of survey responders had experienced a decline in income, while 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic as compared to their colleagues. Conclusion The COVID pandemic will likely have a lasting effect on the practice of medicine. Our survey results describe the early impact on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume which leads to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future.


id: cord-330728-tul659fr
author: Zaed, Ismail
date: 2020-06-11
txt: ./txt/cord-330728-tul659fr.txt
cache: ./cache/cord-330728-tul659fr.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.06.032
doi: 10.1016/j.wneu.2020.06.032
abstract: nan
summary:
  Many medical offices have either made the 40 transition to telemedicine or greatly reduced their patient volumes to accommodate the widely accepted 41 "social distancing" recommendation by the World Health Organization (WHO) and the United States COVID-19 has forced us to rapidly adapt, integrate, and use technology to help us survive during these 46 challenging times. Despite being a very promising 110 technology able to influence neurosurgical training, several barriers still need to be defeated, such as the 111 expensiveness of the acquisition, the significant amount of space that many hospitals and programs do not 112 have for its installation and the fact that even the most modern simulators allow the performance of only a 113 few specific procedures. In more recent times, VR technologies started to be used also 124 in surgical fields, allowing an enhanced training of surgical skills.

title:
  How is COVID-19 going to affect education in neurosurgery? A step toward a new era of educational training


id: cord-334280-qs40g1fz
title: Geospatial Distribution of Neurosurgeons Age 60 and Above Relative to the Spread of COVID-19
author: Jella, Tarun K.
date: 2020-10-14
txt: ./txt/cord-334280-qs40g1fz.txt
cache: ./cache/cord-334280-qs40g1fz.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.10.037
doi: 10.1016/j.wneu.2020.10.037
summary:
  Objective To perform an ecological study in order to analyze the geospatial distribution of neurosurgeons ≥ 60 years old and compare these data with the spread of COVID-19 across the; U.S. Methods Data regarding the distribution of COVID-19 cases was collected from the Environmental Systems Research Institute and demographic statistics from the American Association of Medical Colleges 2019State Workforce Reports. Results As of July 5, 2020, the 10 states with the highest number of COVID-19 cases showed older neurosurgical workforce proportions (the proportion of active surgeons aged 60 years or older) ranging from 20.6% to 38.9%. As 80 a result, this study was performed in order to establish first the geographical distribution of 81 neurosurgeons aged 60 years or older and, secondly, to compare this data to the distribution of 82 COVID-19 cases across the country.

abstract:
  Objective To perform an ecological study in order to analyze the geospatial distribution of neurosurgeons ≥ 60 years old and compare these data with the spread of COVID-19 across the; U.S. Methods Data regarding the distribution of COVID-19 cases was collected from the Environmental Systems Research Institute and demographic statistics from the American Association of Medical Colleges 2019State Workforce Reports. These figures were analyzed using geospatial mapping software. Results As of July 5, 2020, the 10 states with the highest number of COVID-19 cases showed older neurosurgical workforce proportions (the proportion of active surgeons aged 60 years or older) ranging from 20.6% to 38.9%. Among states with the highest number of COVID-19 deaths, the older workforce proportion ranged from 25.0% to 43.4%. Connecticut demonstrated the highest with 43.4% of neurosurgeons 60 years or older. Conclusions Regional COVID-19 hotspots may coincide with areas where a substantial proportion of the neurosurgical workforce is ≥ 60 years of age. Continuous evaluation and adjustment of local and national clinical practice guidelines are warranted throughout the; pandemic era.


id: cord-334521-sa0eyzq7
title: Neurosurgical Interactive Teaching Series: A Multidisciplinary Educational Approach
author: Ramos-Fresnedo, Andres
date: 2020-09-18
txt: ./txt/cord-334521-sa0eyzq7.txt
cache: ./cache/cord-334521-sa0eyzq7.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.09.074
doi: 10.1016/j.wneu.2020.09.074
summary:
  Conclusion: As the world of medicine is constantly changing, we are in need of developing new 18 tools to enhance our ability to relay knowledge through accredited and validated methods onto 19 physicians-in-training, such as the implementation of structured, multi-disciplinary, case-based 20 lectures as presented in this manuscript. Conclusion: As the world of medicine is constantly changing, we are in need of developing new 18 tools to enhance our ability to relay knowledge through accredited and validated methods onto 19 physicians-in-training, such as the implementation of structured, multi-disciplinary, case-based 20 lectures as presented in this manuscript. 13, 14 Based on 23 the multidisciplinary approach, we created a separate weekly lecture format, that is broadcast 24 internationally, where trainees are encouraged to critically prepare (with the help of multiple 25 experts) and review surgical cases for educational purposes.

abstract:
  Objective The goal of this manuscript is to investigate the effects of a multidisciplinary multinational web-based teaching conference on trainee education, research and patient care. Methods We present the structure, case selection and presentation of our educational lectures. We retrospectively reviewed our database to gather data on the number of presentations, type of presentation, and the pathology diagnosis from November 11, 2016 until February 28, 2020. To investigate attendee satisfaction, we analyzed our yearly CME evaluation survey results to report the impact that this series may have had on our attendees. We assigned a numeric value to the answers and the mean overall scores where compared through an ANOVA. Further analysis on specific questions was performed with a Fisher’s exact test. Results We have hosted 150 lectures, in which we have presented 208 neurosurgical cases corresponding to 133 general session, 59 pituitary, and 16 spine cases, as well as 28 distinct lectures by guest speakers from institutions across the globe. We received 61 responses to our yearly CME evaluations over the course of three years. On these evaluations, we have maintained an excellent overall rating from 2017-2019 (two-sided p>0.05) and received significantly less suggestions to improve the series comparing 2017 with 2019 (two-sided, p=0.04). Conclusion As the world of medicine is constantly changing, we are in need of developing new tools to enhance our ability to relay knowledge through accredited and validated methods onto physicians-in-training, such as the implementation of structured, multi-disciplinary, case-based lectures as presented in this manuscript.


id: cord-335642-i0a1si8k
author: Lozada-Martínez, Ivan
date: 2020-11-03
txt: ./txt/cord-335642-i0a1si8k.txt
cache: ./cache/cord-335642-i0a1si8k.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33167148/
doi: 10.1016/j.wneu.2020.08.059
abstract: nan
summary:
  title: Letter to the Editor: "Role of the Neurosurgeon in Times of Coronavirus Disease 2019 (COVID-19): The Importance of Focus in Critical Care" Some authors who have reported the execution of similar changes point out that these transformations have implied real challenges, since they have needed to be rapidly trained in critical care to be able to establish and provide quality support treatment. This consensus in particular sets a road map for the diagnosis and treatment of patients with COVID-19 in a didactic way, as well as a protocol to be followed in intensive care units to facilitate the patient admission process, triage establishment, isolation management, disinfection of the medical equipment and the environment, waste disposal, highly specialized personal protective equipment use, airway management, and ventilatory support, and finally evaluation of neurologic diseases such as stroke, epileptic status, and neuroimmune and neuromuscular diseases, among others.

title:
  Letter to the Editor: ”Role of the Neurosurgeon in Times of Coronavirus Disease 2019 (COVID-19): The Importance of Focus in Critical Care”


id: cord-337269-bh3qbn3q
author: Bajracharya, Aliza
date: 2020-06-11
txt: ./txt/cord-337269-bh3qbn3q.txt
cache: ./cache/cord-337269-bh3qbn3q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.06.027
doi: 10.1016/j.wneu.2020.06.027
abstract: nan
summary:
  title: Scoping the perplexing effect of the COVID pandemic in Nepal, and the appraisal for precautionary measures from its lurking aftermath Scoping the perplexing effect of the COVID pandemic in Nepal, and the appraisal for precautionary measures from its lurking aftermath The coronavirus 2019 (COVID-19) pandemic has led to the global health crisis. By far to contain this infection, the government has ensured isolation facilities, quarantined the suspected cases, and contact tracing of the exposed patient, increased the screening tests, but all these steps are at a snail''s pace. To at least make a start, there needs to be a provision of rapid testing of every high-risk emergency case so as to safeguard the health workers. The referral cases need to have the facility of conducting the test prior to the referral to the center so that it avoids unnecessary delay and the environment of fearful uncertainty while managing them.

title:
  Scoping the perplexing effect of the COVID pandemic in Nepal, and the appraisal for precautionary measures from its lurking aftermath


id: cord-339478-v7by6dnp
author: Kessler, Remi A.
date: 2020-05-08
txt: ./txt/cord-339478-v7by6dnp.txt
cache: ./cache/cord-339478-v7by6dnp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32438002/
doi: 10.1016/j.wneu.2020.04.244
abstract: nan
summary:
  Here we present our detailed institutional experience -from an 1,141-bed, tertiary care academic center and six other affiliate hospitals of the Mount Sinai Health System in NYC-on how the re-organization efforts changed our neurosurgical graduate medical education program from the heart of the pandemic. The changes to neurosurgery resident education at Mount Sinai were borne out of a necessity for re-deployment of our physicians to assist in the fight against COVID-19, given the sheer abundance of positive patients in NYC. The Emory University Department of Neurosurgery reported similar changes for residents covering their neurosurgical service and each resident is to spend one week during the month of April caring for COVID-19 patients. The COVID-19 pandemic has required our department to change resident education to an exceptional degree, but we are continuing neurosurgical learning in innovative ways while heeding the call to care for NYC''s sickest patients.

title:
  Changes in Neurosurgery Resident Education During the COVID-19 Pandemic: An Institutional Experience from a Global Epicenter


id: cord-343322-vx3lub3s
author: LUBANSU, Alphonse
date: 2020-11-02
txt: ./txt/cord-343322-vx3lub3s.txt
cache: ./cache/cord-343322-vx3lub3s.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.10.143
doi: 10.1016/j.wneu.2020.10.143
abstract: nan
summary:
  key: cord-343322-vx3lub3s title: Reply to the Letter to the Editor Regarding " COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center ". cord_uid: vx3lub3s for their interest and valuable questions regarding our recently published paper "COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center". We noted and appreciated that the protocol and workflow for the management of neurosurgical patients that we applied at the early onset of the COVID 19 pandemic, at our institute, seems to be also effectively applied in larger and different countries such as India. On pandemics: the impact of COVID-19 on the practice of neurosurgery Preliminary Recommendations for Surgical Practice of Neurosurgery Department in the Central Epidemic Area of 2019 Coronavirus Infection Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response Countries where Coronavirus has spread -Worldometer

title:
  Reply to the Letter to the Editor Regarding " COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center ".


id: cord-348442-nk3mbwdj
title: Letter to the Editor: Pandemic (COVID-19) Proctoring for eCLIPs Neurointervention
author: O''Kelly, Cian
date: 2020-09-23
txt: ./txt/cord-348442-nk3mbwdj.txt
cache: ./cache/cord-348442-nk3mbwdj.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1878875020316661
doi: 10.1016/j.wneu.2020.07.145
abstract: nan
summary:
  With rapid introduction of novel technology in the field of neurointervention, in-person case proctoring has traditionally been used for the effective and safe dissemination of the use of new endovascular devices. Unfortunately, in-person case proctoring poses numerous challenges in the COVID-19 pandemic environment with proctors needing to travel to treatment centers and work in close proximity with the local neurointerventionalists. As a proof of concept, we present a recent endovascular repair of an aneurysm using a novel device that was proctored virtually using a videoconferencing app. At the treatment center, one device was setup to face the control room monitors allowing remote participants to WORLD NEUROSURGERY 142: 575-576, OCTOBER 2020 www.journals.elsevier.com/world-neurosurgery view the live fluoroscopic images. We have demonstrated successful virtual proctoring of a remote endovascular procedure without the need for specialized videoconferencing equipment. This approach allows proctoring to continue during current pandemic restrictions, but also has implications for supporting training and cases in remote and disadvantaged environments.


id: cord-352388-t0tv0lxs
author: Pressman, Elliot
date: 2020-07-19
txt: ./txt/cord-352388-t0tv0lxs.txt
cache: ./cache/cord-352388-t0tv0lxs.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.07.083
doi: 10.1016/j.wneu.2020.07.083
summary:
  The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 Battle Plan at an academic tertiary care referral center too provide insights for other departments going through the same transition. The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 ''Battle Plan'' 13 at an academic tertiary care referral center to provide insights for other departments planning to go through a similar transition. Data of patients who underwent neurosurgical interventions over a six-month period (January 1 -June 30, 2019), was retrospectively collected from the medical records as a control group for the same neurosurgical service before the COVID-19 pandemic began and averaged to four weeks for proper comparison of the four-week data collected after discontinuing the ''Battle Plan''.

title:
  The Return Back to Typical Practice from the ‘Battle Plan’ of the COVID-19 Pandemic: A Comparative Study

abstract:
  Abstract Background Every aspect of the medical field has been heavily affected by the COVID-19 pandemic and neurosurgical services are no exception. Several departments have reported their experiences and protocols to provide insights for others impacted. The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 Battle Plan at an academic tertiary care referral center too provide insights for other departments going through the same transition. Methods The clinical data of all patients who underwent a neurosurgical intervention between May 4, 2020 and June 4, 2020 was obtained from a prospectively maintained database. Data of the control group was retrospectively collected from the medical records to compare the types of surgeries/interventions and clinic visits performed by the same neurosurgical service before the COVID-19 pandemic started. Results One-hundred sixty-one patients underwent neurosurgical interventions, and seven-hundred one patients were seen in clinic appointments, in the four-week period following easing back from our COVID-19 ‘Battle Plan’. Discontinuing the ‘Battle Plan’ resulted in increases in case load to above average practice after a week but a continued decrease in clinic appointments throughout the four weeks compared to average practice. Conclusions As policy-shaping crises like pandemics abate, easing back to ‘typical’ practice can be completed effectively by appropriately allocating resources. This can be accomplished by anticipating increases in neurosurgical volume, specifically in the functional/epilepsy and brain tumor subspecialties, as well as continued decreases in neurosurgical clinic volume, specifically in elective spine.


id: cord-355271-zynnr776
author: Agrawal, Amit
date: 2020-08-09
txt: ./txt/cord-355271-zynnr776.txt
cache: ./cache/cord-355271-zynnr776.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.08.035
doi: 10.1016/j.wneu.2020.08.035
abstract: nan
summary:
  title: Letter to the editor– "Staying Home Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic Additionally, our apparent impression is that there is decrease in the number cases who are requiring neurosurgical interventions for neurotrauma related conditions. 6, 7 Furthermore, comparative reduction in the number of surgeries may be due to overall decrease in neurotrauma cases and also due to DNR (do not resuscitate) strategies in terminally sick patients. We also observe that probably the reduction in the incidence in neurotrauma cases (needs more studies and objective to support) is due to restriction of nonessential activities, social distancing, less crowding and restricted public as well as private transportation. An epidemiological study of traumatic brain injury cases in a trauma centre of New Delhi (India) Staying Home" -Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic

title:
  Letter to the editor– “Staying Home - Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic


