• Jun Wen, Xiaoming Qi, Kristopher A Lyon, Buqing Liang, Xiangyu Wang, Dongxia Feng, and Jason H Huang.
• Department of Neurosurgery, the First Affiliated Hospital of Jinan University, Guangzhou, China.
• World Neurosurg. 2020 Jun 1; 138: e955-e960.

ObjectiveThe novel coronavirus disease 2019 (COVID-19) pandemic poses a substantial threat to the health of health care personnel on the front line of caring for patients with COVID-19. The Centers for Medicare and Medicaid Services have announced that all nonessential planned surgeries and procedures should be postponed until further notice and only urgent procedures should proceed. Neurologic surgeries and procedures should not be delayed under the circumstance in which it is essential at saving a life or preserving functioning of the central nervous system.MethodsWith the intent to advise the neurosurgery team on how to adequately prepare and safely perform neurosurgical procedures on confirmed and suspected patients with COVID-19, we discuss considerations and recommendations based on the lessons and experience shared by neurosurgeons in China.ResultsPerioperative and intraoperative strategies, considerations, as well as challenges arisen under the specific circumstance have been discussed. In addition, a case of a ruptured aneurysm in a suspected patient with COVID-19 is reported. It is advised that all health care personnel who immediately participate in neurosurgical surgeries and procedures for confirmed and suspected patients with COVID-19 should take airborne precautions and wear enhanced personal protective equipment.ConclusionsFollowing the proposed guidance, urgent neurosurgical surgeries and procedures can be safely performed for the benefit of critical patients with or suspected for COVID-19.Copyright © 2020 Elsevier Inc. All rights reserved.

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