Complex neurosurgery on a patient at risk of developing CJD; Lessons Learned

Mrs Rachel Thomson1, Dr Tara Anderson

1Royal Hobart Hospital, Hobart, Australia


The number of individuals in Australia who meet the classification criteria for ‘low-risk’ for Creutzfeldt-Jacob Disease (CJD) is a relatively small group.  The frequency with which individuals in the ‘low-risk’ group undergo surgery requiring exposure to higher-infectivity tissue is an even smaller group.

In June 2018 a 69 year old female patient in the ‘low-risk’ category for CJD transmission, was admitted over a weekend to the Royal Hobart Hospital.  She had increasing focal symptoms associated with a recently diagnosed large, complex, deep-seated meningioma.

This case presented a set of unique challenges relating to the invasive neurosurgery required to remove this tumour, whilst maintaining capacity to continue to treat subsequent patients in the sole facility undertaking such surgery within Tasmania. The challenges related to the need to potentially quarantine and destroy complex equipment which could not be readily replaced either through loan equipment or substitution.

The ability to both perform this case and maintain surgical capacity required a level of detailed planning with limited time due to the pressing nature of the illness being experienced by the patient.  The application of the current Australian CJD Guidelines required rapid multi-disciplinary interaction and detailed high-level planning.

This presentation will explore the lessons learnt that allowed our organisation to successfully provide complex treatment in a timely manner, whilst allowing retention of advanced neurosurgical capacity within the Tasmanian Public Healthcare system.


To be provided later

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