Emergency cranial neurosurgery in a tertiary care centre: Clinical burden, treatment delays and service challenge

Background

Emergency cranial neurosurgical conditions are time-sensitive, and avoidable in-hospital delay may permitprogression of mass effect, intracranial hypertension, herniation, or secondary neurological injury. This study describes theemergency cranial workload of a newly established tertiary neurosurgical service, identifies modifiable delays, and outlines aprotocol-based service response. Materials and Methods: A retrospective clinical audit was conducted in the Department ofNeurosurgery, ESIC Medical College and Superspeciality Hospital, Hyderabad, from August 2025 to March 2026.Consecutive emergency cranial cases requiring urgent surgery or a definitive neurosurgical disposition were reviewed.Demographic data, presentation, operative procedure, time to operation theatre (OT), causes of delay, and referral wererecorded.