Background The COVID-19 pandemic and the subsequent lockdown have significantly altered many aspects of the health care services. We investigated the impact of the restrictive measures during the pandemic on the volume and spectrum of operated neurosurgical cases at two University hospitals in Egypt. Results The total number of surgeries dropped during the lockdown (second quarter of the year 2020) by 38%, compared with the total number of surgeries in the first quarter of the same year, with an increase in the proportion of urgent surgeries to the total number of surgeries from 46 to 69% (P < 0.001), and a decrease in the proportion of elective surgeries from the total number of neurosurgeries from 54 to 31% (P < 0.001). Similar differences were noted in the volume and spectrum of surgeries in the second quarter of 2020, when compared to the same period of the preceding year (2019). Conclusions The COVID-19 pandemic has significantly altered the nature and volume of neurosurgical practice. The overall number of surgeries showed a marked decline in the lockdown period; however, the numbers of urgent surgeries showed no significant difference under the lockdown.

Background: The pandemic of COVID-19 has a great impact on all health-care services worldwide. Neurosurgical recommendations are to postpone the endoscopic endonasal pituitary surgeries during the pandemic. We would like to express our experience with urgent pituitary adenomas during the current COVID-19 pandemic. Methods: In our country, COVID-19 has started to become a paramount problem by March 2020. Nine cases of pituitary adenomas have presented with urgent manifestations. The endoscopic endonasal approach was performed in eight patients, while a craniotomy was selected for a recurrent pituitary adenoma. Pre- and postoperative thorough clinical evaluations with chest CT scans were performed. Other strict infection control measures have been applied. Results: In 8 weeks duration starting from the past days of February 2020, we have operated on four females and five males of pituitary adenomas. Visual deterioration was the main presenting symptom. The driving factor for surgery was saving vision in eight patients. Fortunately, the postoperative course was uneventful for all patients. No suspected COVID-19 infection has been reported in any patient or health-care team except one patient. In our city, PCR test was routinely not available. Conclusion: In the era of COVID-19, strict infection control precautions should be employed to limit the possibility of transmission of any possible infection to patient or any of the surgical team. We believe that the risk of getting such infection is not increased by the endonasal approach. Long-term follow-up and large numbers of prospective studies are recommended to delineate the impact of COVID-19 infection on pituitary surgeries.

Background: posterior cranial fossa basal lesions including tumors and vascular compression syndromes especially located in cerebellopontine angles (CPA) are considered one of the most complex regions due to crowded anatomy and limitations of visualization during surgery by the microscope alone, so endoscopic use as assisted visualization technique helps greatly in achieving good results, better outcomes and less morbidities. The aim of this work is to assess endoscopic role and importance as assisted tool during microscopic surgery for those lesions in neurosurgery Department in Zagazig University Hospitals from October 2016 to October 2018. Methods: 33 patients included 5 cases of epidermoid, 8 cases of acoustic Schwannomas, 4 meningiomas, 10 cases of Hemifacial spasm and 6 cases of trigeminal neuralgia. in this study we used the endoscope as assisted tool to the microscope, initial dissection by the microscope then the endoscope was used to navigate in the area to detect and demonstrate the pathology and its relations to the surrounding structures, then most of the work is microscopic and the endoscope is used in different stages to detect any residuals of tumors, hidden parts, any injuries, may be used to dissect in some situations if needed, position of insulators in microvascular decompression and final view after finishing the surgery. Results: Endoscopy provided improved visualization of local anatomy, revealed hidden lesions and reduced unnecessary anatomical distortions.Conclusion: endoscopic aided technique greatly helps surgical management of CPA lesions and other disorders. This minimally invasive technique overcomes many shortcomings inherent to the traditional retrosigmoid approach. The use of the endoscope in the CPA as a tool to increase the extent of resection, minimize complications, and preserve the function of the delicate CPA structures

Background: Colloid cysts are considered rare benign tumors at the 3 rd ventricle. Best surgical option for such tumors has not been established, however endoscopic approaches have been gaining popularity and have been proved to be an effective modality. We aimed to assess surgical outcomes of endoscopic resection of colloid cysts with evaluation of extent of resection and rate of complications. Materials and methods:A retrospective cohort study was conducted to investigate surgical outcomes of patients who had undergone endoscopic resection of colloid cyst. Pre-operative clinical and radiological data were collected. Operative details, extent of resection and postoperative complications were estimated. Results: In this study 27 cases had undergone endoscopic resection of colloid cyst in the period from January 2016 to January 2021. Patients were of mean age 32.7±10.9 years (17 patients were males). Headache was the most common presentation in (81.5%) of our patients. Complete resection was reported in 22 cases (81.5%), while subtotal resection with coagulation of residual adherent parts was done in 5 cases (18.5%).3 patients (11.1%) had postoperative wound infection, 2 patients (7.4%) experienced postoperative transient memory deficits, and only one patient (3.7%) had postoperative fulminant meningitis, and this was our mortality case. EVD was inserted in 9 patients (33.3%), but only 2 patients (7.4%) who further had a permanent VP shunt. Conclusion: Endoscopic resection of 3 rd ventricle colloid cysts is an effective procedure that provides gross total resection in most patients and has lower morbidity and mortality rates.