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They have learned how to provide the best possible care despite personnel shortages and overwhelming patient volumes, including many patients who are critically ill with systemic as well as neurological injuries. Outcomes are better than many might expect. International support and collaboration have been instrumental in achieving these good outcomes. Mechnikov Hospital neurosurgeons have developed new patient care pathways and management techniques that they disseminate internationally through publications and academic conferences. Prospective studies and other research activities are underway despite the obvious challenges caused by the war. 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