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The COVID-19 pandemic has significantly affected patient care across specialties. Ramifications for neurosurgery include substantial disruptions to surgical training and changes in nonurgent patient presentations to the emergency department. This study quantifies the effects of the COVID-19 pandemic on the number of emergency department patients who were referred to the neurosurgery department for further consultation and treatment and identifies and describes trends in the characteristics of these visits.A retrospective review was performed of neurosurgical consultations at a single high-volume institution for 28 call-day periods before and after the official announcement of the pandemic. Primary outcomes included consultations per call-day, patient presentation category, and patient admission.The neurosurgical service was consulted regarding 629 patients (367 male patients) during the study period, with 471 (75%) and 158 (25%) patients presenting before and after the announcement of the COVID-19 pandemic, respectively. The mean number of neurosurgical consultations per call-day was significantly lower in the COVID-19 period (5.6 consultations) compared with the pre-COVID-19 period (16.8 consultations) (P0.001). After adjusting for patient demographics, the rate of presentation for general nonurgent concerns, such as back pain, headaches, and other general weaknesses, significantly decreased (odds ratio [95% confidence interval], 0.60 [0.47-0.77], P0.001).Neurosurgical consultations significantly decreased after the onset of the COVID-19 pandemic, with a substantially lower overall number of consultations necessitating operative interventions. Furthermore, the relative number of patients with nonemergent neurological conditions significantly decreased during the pandemic.

In the COVID-19 era, among the main benefits that telemedicine provides to the neurosurgeon, we can mention that it allows the neurosurgeon to reach the patient remotely without being exposed to patients who could be positive for COVID-19;enables the neurosurgeon to use time more efficiently;facilitates the neurosurgeon to differentiate routine cases from neurosurgical emergencies and to decide a behavior;expedites preparation to receive and evaluate patients upon admission to hospital;and it allows the neurosurgeon monitor patients properly, e g , the postoperative controls, vascular pathology, and brain tumors, which lend themselves to easier evaluation through telehealth visits In the COVID-19 era, the main advantages offered by telemedicine for a patient are that it provides greater availability of health care for populations with inconveniences to receiving medical care, especially for specialized medical care such as neurosurgery;eliminates geographic barriers while adhering to COVID-19 safety guidelines;patients can avoid traveling (and being exposed to the virus);and reduces lost work due to hospital visits and reduces patient expenses Likewise, it allows patients to be adequately examined according to their symptomatology, along with their medical and surgical history, allowing them to be identified as potential candidates for surgical intervention or conservative treatment Current circumstances have encouraged more neurosurgeons to establish telemedicine as part of their daily practice, not only on the job side but also on the academic side, in the case of being a professor In this way, knowing the many benefits that telemedicine provides for both neurosurgeon and patients, we urge neurosurgical centers to take advantage of this alternative provided by technology and to educate patients in its correct use, to ensure their safety, to reduce the spread of severe acute respiratory syndrome coronavirus 2 among physician-patients, and to contribute to a decrease in global statistics

Dear Editor, In spite of many published series, the incidence of post-traumatic endocrine dysfunction is a matter of debate. Many logistics and economic issues have been discussed relating to inves...

Subarachnoid hemorrhage (SAH) is a neurological emergency occurring frequently and has significant morbidity and mortality. Etiological classification divides it into traumatic and nontraumatic or spontaneous. Even though it has been referred that these are almost the same pathology, there is a slight difference between them regarding several aspects, such as epidemiological, pathophysiological, clinical, and diagnostic approach and treatment. These differences deserve detailed understanding to help physicians treat this disease more efficiently. We reviewed all available literature regarding these two types of SAH and tried to elicit differences between them with respect to etiology and treatment. The differences were made keeping in mind the utility of the same to a general physician so that rapid and informed decisions can be made at that level. Pathophysiological differentiation of these two diseases is of paramount importance, and etiological diagnosis determines prognosis. Knowledge of the same is essential and lifesaving.