Adaptations in radiosurgery practice during COVID crisis

Background: The world is in the midst of the COVID crisis, which has forced the neurosurgical community to change its practices. Objective: To advocate the necessary adaptations in radio surgical practices to effectively manage the radio surgical patients, resource utilization, and protecting the healthcare provider during the COVID pandemic. Material and Methods: In addition to the literature review, pertinent recommendations are made in respect to the gamma knife radiosurgery (GKRS). Results: Every patient presenting to GKRS treatment should be considered as a potential asymptomatic COVID carrier. Patients should be categorized based on the priority (urgent, semi-urgent, or elective) on the basis of pathological and clinical status. The only urgent indication is a non-responding or enlarging cerebral metastasis. There is a high risk of aerosol dispersion during gamma radiation delivery in the gamma gantry. Conclusion: These recommendations should be used to minimize the chances of pathogenic exposure to the patient and caregivers both.