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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(02): 136-137
DOI: 10.1055/s-0040-1716937
Short Communication

Unlocking in COVID Times: The Neurosurgical Way

Samir Kumar Kalra 
1   Department of Neurosurgery, Sir Ganga Ram Hospital & Ganga Ram Institute of Medical Education & Research, New Delhi, India
,
Vandana Kalra 
2   Department of Radiology, Delhi Heart & Lung Institute, New Delhi, India
,
Raj Kumar
3   Department of Neurosurgery, UP University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
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Abstract

The humankind is facing one of the worst nightmares in the form of the ongoing Corona crisis. The pandemic has spread all across the globe and we are struggling to deal with its might. All nations have made their own strategies to deal with this situation and mainly a phase of lockdown has been the savior in most countries, especially India, where it was enforced early and well in time. After a successful lockdown, there is a phase of unlocking, which is equally important. One should exercise caution in that this should be done gradually and phased, with all the precautions in place and without any complacency. Neurosurgeons are faced with a situation pertaining to those afflicted by posterior fossa lesions with hydrocephalus. They are treated with ventriculoperitoneal shunt, but sometimes they develop reverse tentorial herniation. This needs prompt evaluation and intervention and carries a poor prognosis if untreated. Another situation is where bifrontal contusions need decompressive surgery; some patients develop encephaloceles and extradural hematomas following successful surgery and complicate the prognosis. Both situations emerge due to sudden decompression, leading to quick changes in brain pressure and perfusion. The solution is slow and careful decompression, with all precautions in place despite the temptation of eureka moments. A similar response could be desirous over the course of our unlocking period. Hope this wisdom brings us good results in these Corona times.

Keywords

COVID 19 - reverse herniation - upwards tentorial herniation


Publication History

Article published online:
19 April 2021

© 2021. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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