Abstract:
OBJECTIVE:Global outbreak of the novel coronavirus disease 2019 (COVID-19) has forced healthcare systems worldwide to reshape their facilities and protocols. Although not considered the frontline specialty in managing COVID-19 patients, neurosurgical service and training were also significantly affected. This article focuses on the impact of the COVID-19 outbreak at a low- and/or middle-income country (LMIC) academic tertiary referral hospital, the university and hospital policies and actions for the neurosurgical service and training program during the outbreak, and the contingency plan for future reference on preparedness for service and education. METHODS:The authors collected data from several official databases, including the Indonesian Ministry of Health database, East Java provincial government database, hospital database, and neurosurgery operative case log. Policies and regulations information was obtained from stakeholders, including the Indonesian Society of Neurological Surgeons, the hospital board of directors, and the dean's office. RESULTS:The curve of confirmed COVID-19 cases in Indonesia had not flattened by the 2nd week of June 2020. Surabaya, the second-largest city in Indonesia, became the epicenter of the COVID-19 outbreak in Indonesia. The neurosurgical service experienced a significant drop in cases (50% of cases from normal days) along all lines (outpatient clinic, emergency room, and surgical ward). Despite a strict preadmission screening, postoperative COVID-19 infection cases were detected during the treatment course of neurosurgical patients, and those with a positive COVID-19 infection had a high mortality rate. The reduction in the overall number of cases treated in the neurosurgical service had an impact on the educational and training program. The digital environment found popularity in the educational term; however, digital resources could not replace direct exposure to real patients. The education stakeholders adjusted the undergraduate students' clinical postings and residents' working schemes for safety reasons. CONCLUSIONS:The neurosurgery service at an academic tertiary referral hospital in an LMIC experienced a significant reduction in cases. The university and program directors had to adapt to an off-campus and off-hospital policy for neurosurgical residents and undergraduate students. The hospital instituted a reorganization of residents for service. The digital environment found popularity during the outbreak to support the educational process.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Suryaningtyas W,Wahyuhadi J,Turchan A,Subagio EA,Parenrengi MA,Apriawan T,Al Fauzi A,Bajamal AHdoi
10.3171/2020.9.FOCUS20559subject
Has Abstractpub_date
2020-12-01 00:00:00pages
E5issue
6issn
1092-0684pii
2020.9.FOCUS20559journal_volume
49pub_type
杂志文章abstract::Cervical dural arteriovenous fistulas (dAVFs) are a rare cause of intracranial subarachnoid hemorrhage (SAH) but should be considered when other sources are not found. Subarachnoid hemorrhage caused by dAVF is thought to occur as a result of venous hypertension in most cases. The clinical presentation, acute onset of ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC.2009.26.1.E4
更新日期:2009-01-01 00:00:00
abstract::In January 1994, the Guidelines and Outcomes Committee of the American Association of Neurological Surgeons (AANS) issued a charge to develop practice parameters to treat adult patients with low-grade glioma (LGG). This area of study was chosen because of a similar interest on the part of the American Academy of Neuro...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1998.4.1.11
更新日期:1998-06-15 00:00:00
abstract::High-flow microinfusion is a novel technique for delivery of compounds directly into the brain parenchyma, bypassing the blood-brain barrier. The feasibility of this technique has been demonstrated with low-molecular-weight compounds, macromolecular dyes, and proteins. Delivery of antisense oligonucleotides into the b...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.3.5.7
更新日期:1997-11-15 00:00:00
abstract::The development of less invasive methods to evacuate intracerebral hematomas (ICHs) has improved outcome in patients with traumatic brain injury. Eighteen patients with ICHs underwent surgery via one of two methods: stereotactic endoscopic removal (SER) or stereotactic catheter drainage (SCD). The outcome results were...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1996.1.4.2
更新日期:1996-10-15 00:00:00
abstract::OBJECTIVE The best management of veins encountered during the neurosurgical approach is still a matter of debate. Even if venous sacrifice were to lead to devastating consequences, under certain circumstances, it might prove to be desirable, enlarging the surgical field or increasing the extent of resection in tumor s...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.4.FOCUS18120
更新日期:2018-07-01 00:00:00
abstract:OBJECT:The goal of this study was to review the management of intra- and extradural ependymomas. Spinal ependymomas most commonly occur as intramedullary tumors throughout the spinal axis. In the lumbosacral region, ependymomas are most commonly associated with the conus medullaris and cauda equina, but can also occur ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.5.13
更新日期:2003-11-15 00:00:00
abstract::The authors report the history of the Tabulae Anatomicae of Bartolomeo Eustachio (ca. 1510-1574). In the tables, the anatomical illustrations were drawn inside a numerical frame, with pairs of numbers on the y- and x-axes to identify single anatomical details in the reference table. The measures and the references cou...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2019.6.FOCUS19339
更新日期:2019-09-01 00:00:00
abstract::Advances in medical and surgical treatments in the last few decades have resulted in quantum leaps in the overall survival of patients with malignant disease outside the central nervous system, whereas survival of patients with malignant gliomas (World Health Organization Grades III and IV) has remained essentially un...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2006-04-15 00:00:00
abstract::Surgery for cranial deformity was associated with significant surgical morbidity during the early part of the 20th century. For this reason, Harvey Cushing was initially not in favor of surgical treatment of craniosynostosis. Later in his career, Cushing began to operate on these children, although it never became a m...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2010.9.FOCUS10191
更新日期:2010-12-01 00:00:00
abstract::Perioperative abdominal complications associated with spine surgery are rare. Although most known abdominal complications occur in conjunction with anterior spinal fusions, there is a paucity of reports reviewing abdominal complications occurring with posterior spinal fusions. The authors review 4 patients who experie...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.8.FOCUS11132
更新日期:2011-10-01 00:00:00
abstract::Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19441
更新日期:2019-10-01 00:00:00
abstract::In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.1.FocusVid.17572
更新日期:2018-01-01 00:00:00
abstract::Iatrogenic intervertebral disc space infection is encountered following microsurgical discectomy, percutaneous laser disc decompression, automated percutaneous lumbar nucleotomy operations, and discography. The purpose of this paper is to present a case report and review the literature on the uncommon origins of pyoge...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-06-15 00:00:00
abstract:OBJECT:The safety and effectiveness of osteogenic protein (OP)-1 putty (recombinant human bone morphogenetic protein-7) in promoting fusion in complex spinal cases was studied in nine cases. METHODS:The authors prospectively evaluated nine patients requiring spinal fusion in whom there were medical risk factors that w...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.6.5
更新日期:2002-12-15 00:00:00
abstract:OBJECT:Obesity as a consequence of management of pediatric craniopharyngioma is a well-described phenomenon related to the degree of hypothalamic involvement. However, weight change and obesity have not been analyzed in adult patients. Therefore, the purpose of this study was 1) to evaluate the pattern of postoperative...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.1.FOCUS09303
更新日期:2010-04-01 00:00:00
abstract::The surgical management of compressive cervical ossification of the posterior longitudinal ligament (OPLL) can be challenging. Traditionally, approach indications for decompression of cervical spondylotic myelopathy have been used. However, the postoperative complication profile after cervical OPLL decompression is un...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.1.FOCUS10278
更新日期:2011-03-01 00:00:00
abstract::OBJECTIVE The microscopic transoral, endoscopic transnasal, and endoscopic transoral approaches are used alone and in combination for a variety of craniovertebral junction (CVJ) pathologies. The endoscopic transoral approach provides a more direct exposure that is not restricted by the nasal cavity, pterygoid plates, ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.11.FOCUS15498
更新日期:2016-02-01 00:00:00
abstract::Forty-four patients with cervical spondylotic myelopathy who underwent a ventral surgical approach were evaluated with respect to the results of surgery. The neurological status of the patients was categorized according to the modified Japanese Orthopedic Association scale (0-18). Three patients had a functional score...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1996.1.6.6
更新日期:1996-12-15 00:00:00
abstract::While the majority of cerebral revascularization advancements were made in the last century, it is worth noting the humble beginnings of vascular surgery throughout history to appreciate its progression and application to neurovascular pathology in the modern era. Nearly 5000 years of basic human inquiry into the vasc...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2018.11.FOCUS18527
更新日期:2019-02-01 00:00:00
abstract::OBJECTIVEFew studies have been published specifically examining intravenous drug abuse (IVDA)-associated spinal epidural abscesses (SEAs), an unfortunate sequela of the opioid crisis in the United States. Here, the authors examined a series of patients with IVDA-associated SEAs in order to shed light on this challengi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.10.FOCUS18449
更新日期:2019-01-01 00:00:00
abstract:OBJECT:This paper describes a consecutive series of skull base meningiomas resected using an endoscopic endonasal approach through various corridors at a single institution over 7 years. The impact of case selection and experience, the presence of a cortical cuff between the tumor and surrounding vessels, and brain ede...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.7.FOCUS14321
更新日期:2014-01-01 00:00:00
abstract:OBJECT:The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. METHODS:The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization be...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.12.FOCUS11323
更新日期:2012-05-01 00:00:00
abstract::Since its inception, one of the major issues in transsphenoidal surgery has been the adequate visualization of anatomical structures. As transsphenoidal surgery evolved, technical advancements improved the surgical view of the operative field and the orientation. The operating microscope replaced Cushing's headlight a...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章,评审
doi:10.3171/foc.2005.19.6.4
更新日期:2005-12-15 00:00:00
abstract::Early neurosurgical procedures dealt mainly with treatment of head trauma, especially skull fractures. Since the early medical writings by Hippocrates, a great deal of respect was given to the dura mater, and many other surgeons warned against violating the dura. It was not until the 19th century that neurosurgeons st...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2014.2.FOCUS13564
更新日期:2014-04-01 00:00:00
abstract::The authors present a brief and selective history of surgery for peripheral nerve tumors to illustrate how the current understanding of the nature of disease influences the choice of surgical intervention. There was very little understanding of the anatomy and function of peripheral nerves in ancient times; consequent...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/foc.2007.22.6.2
更新日期:2007-06-15 00:00:00
abstract::Cerebral venous sinus thrombosis (CVST) is characterized by formation of widespread thrombus within the cerebral venous sinus system. CVST can cause venous hypertension, venous infarcts, hemorrhage and seizures. It is managed in most cases with systemic anticoagulation through the use of heparin to resolve the thrombu...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V2.FOCUS14186
更新日期:2014-07-01 00:00:00
abstract::A case is described of an elderly woman who presented with headaches, hypopituitarism, and visual disturbances and was found to have idiopathic granulomatous hypophysitis, a rare lesion of the pituitary gland. Preoperative magnetic resonance imaging demonstrated a well-circumscribed lesion, which was isointense on bot...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1996.1.6.8
更新日期:1996-07-15 00:00:00
abstract::Throughout his illustrious career, Percival Bailey made numerous contributions to the fields of neurology, neuroanatomy, psychiatry, neuropathology, and, of course, neurosurgery. His expertise, his curiosity about the nervous system, and his desire to examine it from all angles were unique. With the exception of Harve...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章,评审
doi:10.3171/foc.2005.18.4.8
更新日期:2005-04-15 00:00:00
abstract::Resection of intramedullary spinal cord tumors carries a high risk for surgical damage to the motor pathways. This surgery is therefore optimal for testing the performance of intraoperative motor evoked potential (MEP) monitoring. This report attempts to provide evidence for the accurate representation of patients' pr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1998.4.5.4
更新日期:1998-05-15 00:00:00
abstract::OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patie...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.10.FOCUS15456
更新日期:2016-01-01 00:00:00