Awake craniotomy in a Covid-19 positive patient: The challenges and outcome

BACKGROUND: The SARS-COV-2 is a novel coronavirus which is the etiological agent of the COVID-19 infection. The neurosurgical practice is not exempted from the impact of the COVID-19 pandemic. Awake craniotomy in a COVID-19 positive patient pose a significant risk for theatre staff but intubation of a COVID-19 positive patient for surgery under general anesthesia also pose similar risk. METHOD: Federal Teaching Hospital Ido Ekiti is a tertiary hospital in suburban community in Southwest Nigeria with 300-bed capacity. The hospital is a designated COVID-19 treatment centre. A 69-year-old female patient was referred from a nearby COVID-19 treatment hospital on account of left parieto-occipital high grade glioma. She had awake craniotomy and gross total tumor excision. RESULT: There was no need to convert to general anesthesia and she had immediate post-operative neurological improvement. Repeat COVID-19 test on post-operative day 4 was negative and she was discharged home. Thirty-day post-operative review confirmed progressive motor gain. CONCLUSION: Awake craniotomy in COVID-19 positive patient with appropriate use of necessary PPEs is achievable.