The novel coronavirus disease 2019 (COVID-19) is an emerging disease, caused by severe acute respiratory syndrome coronavirus-2. It bears unique biological characteristics, clinical symptoms and imaging manifestations, therefore presenting an important and urgent threat to global health. As a result, a new public health crisis arose, threatening the world with the spread of the 2019 novel coronavirus. Despite the maximal worldwide public health responses aimed at containing the disease and delaying its spread, many countries have been confronted with a critical care crisis, and even more, countries will almost certainly follow. In Slovenia, the COVID-19 has struck the health system immensely and among all the specialities, neurosurgery has also been experiencing difficulties in the service, not only in regular, elective surgeries but especially during emergencies. The management of these neurosurgical patients has become more difficult than ever. We describe our protocol in the management of neurosurgical patients in the University Medical Centre Ljubljana, Slovenia and how neurosurgical pathology was tackled during the pandemics.

The novel coronavirus disease 2019 (COVID-19) is an ongoing disease caused by severe acute respiratory syndrome coronavirus-2 that still poses an important and urgent threat to global health. In Slovenia, the epidemic was declared on March 12 th , 2020, and since then COVID-19 has had a great impact on our health system. The field of neurosurgery in particular has been experiencing difficulties in both elective and emergency service. In this article, we described epidemiologic protocols and the effect that the COVID-19 pandemic had on the surgical practice and workflow of the Department of Neurosurgery at the University Medical Centre Ljubljana. We analyzed and compared the number of elective and emergency neurosurgical procedures in a 2-year period before and during the pandemic. We recorded a drop in cases mostly on account of elective procedures whilst emergency service remained relatively unaffected.

Introduction: The novel coronavirus disease 2019 (COVID-19) became an important and urgent threat to global health. In Slovenia, the COVID-19 struck the health system immensely. Neurosurgery experienced difficulties, not only in regular, elective surgeries, but also during emergency situations. Methods: In the article, we analyse and compare the number of elective and emergency neurosurgical procedures during the time of the pandemic (from March 2018 to February 2020) and describe our protocol in the management of neurosurgical patients in the Medical Centre in Ljubljana, Slovenia. Results: There were 2597 patients treated surgically, including 1932 emergency patients and 665 emergency patients. Overall, we recorded an 11.2% drop in all neurosurgical procedures in two years after COVID-19 was declared compared to two years before. Elective procedures decreased by 13.9%, mostly on account of spinal pathology procedures (245, 23.5%), functional neurosurgical procedures (37 cases, 24.7%), endonasal endoscopy procedures (11, 12.8%), and brain lesions (31, 4.8%). Conclusion: COVID-19 had a vast impact on the healthcare system in Slovenia, including on neurosurgery. New and improved strategies to maintain neurosurgical practice during public health emergencies are necessary for the neurosurgical service and healthcare system to run smoothly in the long term and prevent disruptions during future pandemics.

Central nervous system (CNS) infections are urgent conditions with high morbidity and mortality. Bacteria, viruses, parasites or fungi can cause them. Intracranial infections after craniotomies are an important complication of treatment, especially in oncological patients that are already immunologically compromised due to the disease and treatment. The consequence of CNS infections in oncological patients includes longer treatment with antibiotics, additional surgical procedures, higher treatment costs and poorer treatment outcomes. Additionally, the management of primary pathology may be prolonged or postponed as a result of the active infection. By introducing new and improved protocols, tightening controls on their implementation, constantly educating the entire team involved in patient treatment and educating both patients and relatives, the incidence of infections can be reduced effectively.