Prioritizing Neurosurgical Emergencies During and Beyond the COVID-19 Pandemic

The COVID-19 pandemic has drastically reshaped the landscape of healthcare, especially in the realm of neuro and neurosurgical emergencies. These unprecedented times have demanded rapid innovation, collaborative spirit, and adaptive strategies from both hospitals and healthcare professionals. As we continue to manage the effects of the pandemic, one critical priority remains unchanged: the urgent and uninterrupted care of neurological and neurosurgical emergencies.

At Rela Institute, we have ensured our neurological services remain available 24×7, even amidst pandemic constraints. Neurological emergencies, including acute ischemic stroke, status epilepticus, CNS infections, and Guillain-Barré Syndrome (GBS), require prompt recognition and immediate intervention to prevent long-term deficits and improve patient outcomes.

For instance, in the case of acute ischemic stroke, the mantra remains “Time is Brain.” Immediate treatment through thrombolysis (within 4.5 hours of onset) or mechanical thrombectomy (within 24 hours) significantly improves recovery and reduces disability. Similarly, in GBS, where patients may experience sudden paralysis, timely nerve conduction studies followed by early treatment are essential to prevent respiratory complications and support neurological recovery. In status epilepticus, swift control of seizures is critical to minimize brain injury. Likewise, early diagnosis and aggressive treatment of central nervous system infections can greatly enhance the chances of full neurological recovery.

In addition to these neurological emergencies, neurosurgical emergencies have also been carefully triaged and addressed with urgency. These include:

• Cranial and spinal trauma
• Cerebral hemorrhages (subarachnoid and intraparenchymal)
• Acute hydrocephalus
• Brain tumors are at risk of intracranial hypertension
• Spinal cord compression with neurological deficit

Special priority is given to neuro-oncological pathologies, classified based on urgency:

• Immediate intervention is provided for patients with rapidly evolving intracranial hypertension, acute hydrocephalus, or spinal cord compression with sudden neurological decline.
• Early surgical treatment (within 7–10 days) is arranged for patients with significant mass effect from brain tumors or progressive neurological symptoms, even if consciousness remains unaffected.

We have implemented standardized systems of care, including maintaining a steady supply of personal protective equipment (PPE) and establishing special triage zones within the emergency department. Every patient, including those who are COVID-positive, from containment zones, or with potential exposure, is evaluated and treated without delay in a safe, secluded environment by protected staff.

Our “no-wait” policy ensures that time-sensitive neurological and neurosurgical care is never compromised, regardless of the patient’s COVID-19 status. These protocols not only prioritize patient care but also safeguard the health of our medical teams.

As we navigate this challenging period, our commitment remains unwavering: to deliver fast, effective, and compassionate care to all patients in need of urgent neurological or neurosurgical intervention. With collective resilience, we look forward to a future free from the grip of this global health crisis.