Background Containment measures for COVID-19 have affected surgical training globally. We sought to assess how neurosurgical training has been affected across Africa in April 2020. Methods A cross-sectional survey was distributed to African Neurosurgical trainees seeking to review demographics and effects of COVID on training. Results A total of 123 neurosurgery trainees responded from 23 African countries and a further 6 were abroad. A total of 91.80% were men, and 96.70% were training in public institutions. Only 41% had received training in COVID-19 with 61.79% worried that they would contract COVID-19 while performing their clinical duties. There was a marked reduction in clinical activities including a median reduction of elective surgery (−80%), clinics (−83%), and emergency surgery (−38.50%). A total of 23.58% of residents did not receive a formal salary, with 50% on less than $1000 USD gross per month. Conclusions This is the first continental survey of neurosurgery trainees in Africa. COVID-19 has significantly affected clinical and learning opportunities. There are concerns of the long-term effects on their training activities for an uncertain period of time during this pandemic. Although there has been a global increase in e-learning, there is need to evaluate if this is accessible to all trainees.

A tumor growing into a venous sinus is a rare cause of venous outflow impairment and may generate the clinical signs of idiopathic intracranial hypertension. This case emphasizes the importance of multiple complementary imaging modalities and the efficacy of a direct surgical approach, which allowed resolution of symptoms.

No abstract

Introduction COVID-19 has affected the global provision of neurosurgical services. We sought to review the impact of COVID-19 on the neurosurgical services in Africa. Methods A cross-sectional survey was distributed to African neurosurgeons seeking to review demographics, national and neurosurgical preparedness, and change in clinical services in April 2020. Results A total of 316 responses from 42 countries were received. Of these, 81.6% of respondents were male and 79.11% were under the age of 45 years. In our sample, 123 (38.92%) respondents were in training. Most (94.3%) respondents stated they had COVID-19 cases reported in their country as of April 2020. Only 31 (41.50%) had received training on managing COVID-19. A total of 173 (54.70%) respondents were not performing elective surgery. There was a deficit in the provision of personal protective equipment (PPE): surgical masks (90.80%), gloves (84.80%), N95 masks (50.80%), and shoe covers (49.10%). Health ministry (80.40%), World Health Organization (74.50%), and journal papers (41.40%) were the most common sources of information on COVID-19. A total of 43.60% had a neurosurgeon in the COVID-19 preparedness team; 59.8% were concerned they may contract COVID-19 at work with a further 25.90% worried they may infect their family. Mental stress as a result of COVID-19 was reported by 14.20% of respondents. As of April 2020, 73.40% had no change in their income. Conclusions Most African countries have a national COVID-19 policy response plan that is not always fully suited to the local neurosurgery services. There is an ongoing need for PPE and training for COVID-19 preparedness. There has been a reduction in clinical activities both in clinic and surgeries undertaken.

No abstract

The clinical symptoms, serological results and computed tomographic findings of two Zimbabwean children, one with the early meningeal and one with the late parenchymatous form of congenital neurosyphilis are reported. The paediatrician's suspicion of the existence of this condition should remain high as long as syphilis continues to flourish worldwide.

There is no doubt that the development of neurosurgery in general and paediatric neurosurgery in particular has lagged behind in many African countries, and in some unfortunate areas there is not even one single neurosurgeon. In contrast to this alarming situation, there are some excellent neurosurgical centres in northern and southern Africa, which developed fairly rapidly in the 1960s. To date, there are still striking contrasts in Africa where, of the neurosurgeons who are present there at all, some work in extremely difficult conditions while others have better facilities comparable to those in some of the best centres in the world. There is a general strong desire for neurosurgery in Africa to be developed using first what is available locally, then what is available in Africa and only then to turn to the world at large, and there is also consensus that this is the way to proceed. This paper will analyse the current status of paediatric neurosurgery in Africa and the problems that are hampering its development, and suggestions will be made about its future development. It is obvious that Africa is a huge continent and it might sound rather presumptuous to pretend to speak for it in detail. Taking account of this limitation, I will speak mostly about what is accepted nowadays as fact and reality common to most African countries, and for illustrative purposes some details will be given from Zimbabwe, which is where I practice.

No abstract