Clipping of a ruptured middle cerebral artery aneurysm in a patient with Coronavirus disease 2019 (COVID-19): a case report

Kostyra, Kacper; Nowak, Błażej; Kostkiewicz, Bogusław

AIM OF THE STUDY: The aim of this study is to present our suggestions for organization, personal protective equipment (PPE) use, work flow of the operating theater, and the treatment of patients with COVID-19 and co-existing neurological disease. MATERIALS AND METHODS: We present the case of a 70-year-old male who was transferred to our Department because of subarachnoid hemorrhage with ruptured right middle cerebral artery aneurysm and SARS CoV-2 infection. The emergency clipping of the aneurysm and hematoma evacuation was performed. According to the therapeutic committee guidelines, chloroquine was started for COVID-19 treatment. RESULTS: Postoperatively, the patient is in good condition, with the Glasgow Coma Scale (GCS) score of 15, with mild, left hemiparesis, 4 + / 5 points on the Lovett scale, without symptoms of acute respiratory distress syndrome (ARDS). No one from the stuff was infected during the treatment. CONCLUSIONS: Managing patients with infectious diseases such as COVID-19 presents many challenges and risks for healthcare personnel. Our experience suggests that by following strict safety protocols of PPE use, donning and doffing, and reducing operation time, the surgery may be safe for both the healthcare personnel and the patient.