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Background The COVID-19 pandemic has exerted a significant impact on health-care workers. Recent publications have reported the detrimental effects of the pandemic on neurosurgery residents in North America, Asia and Italy. However, the impact of the pandemic on neurosurgical training in Latin America and Spain has not been yet reported. In the present report we describe effects of COVID-19 on training and working conditions of neurosurgery residents in these countries. Methods An electronic survey with 33 questions was sent to neurosurgery residents between September 7, 2020 to October 7, 2020. Statistical analysis was made in IBM SPSS Statistics 25. Results 293 neurosurgery residents responded. Median age was 29.47 ± 2.6 years, 79% (n = 231) were male. 36.5% (n = 107) were of residents training from Mexico. 42% surveyed reported COVID-symptoms and two (0.7%) received ICU care. 61.4% of residents had been tested for COVID and 21.5% had a positive result. 84% of the respondents mentioned persisted with same workload (≥70 hours per week) during the pandemic. Most of residents from Mexico were assigned to management of COVID patients compared to the rest of the countries (88% vs 68.3%, p <0.001); mainly in the areas of medical care (65.4% vs 40.9%, <0.001), mechanical ventilators (16.8% vs 5.9%, p=0.003) and neurological surgeries (94% vs 83%, p=0.006). Conclusion Our results offer a first glimpse of the changes imposed by the COVID-19 pandemic to neurosurgical work and training in Latin America and Spain, where health systems rely strongly on resident workforce.

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Background: Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic represents an important negative impact on global training of neurosurgery residents. Even before the pandemic, discrimination is a challenge that neurosurgical residents have consistently faced. In the present study, we evaluated discriminatory conditions experienced by residents during their neurosurgical training in Mexico before the SARS-CoV-2 pandemic. Methods: An electronic survey of 18 questions was sent among residents registered in the Mexican Society of Neurological Surgery (MSNS), between October 2019 and July 2020. Statistical analysis was made in IBM SPSS Statistics 25. The survey focused on demographic characteristics, discrimination, personal satisfaction, and expectations of residents. Results: A response rate of 50% (132 of 264 residents’ members of MSNS) was obtained and considered for analysis. Median age was 30.06 ± 2.48 years, 5.3% (n = 7) were female and 16.7% (n = 22) were foreigners undergoing neurosurgical training in Mexico. Approximately 27% of respondents suffered any form of discrimination, mainly by place of origin (9.1%), by gender (8.3%) or by physical appearance (6.1%). About 42.9% (n = 3) of female residents were discriminated by gender versus 6.4% (n = 8) of male residents (P = 0.001); while foreign residents mentioned having suffered 10 times more an event of discrimination by place of origin compared to native Mexican residents (36.4% vs. 3.6%, P < 0.001). Conclusion: This manuscript represents the first approximation to determine the impact of discrimination suffered by residents undergoing neurosurgical training in Mexico before the SARS-CoV-2 pandemic.

BACKGROUND Focal cortical dysplasias (FCD) represent highly intrinsically epileptogenic lesions that require complete resection for seizure control. Resection of pure motor strip FCD can be challenging. Effective control of postoperative seizures is crucial and extending the boundaries of resection in an eloquent zone remains controversial. OBSERVATIONS The authors report a 52-year-old right-handed male with refractory epilepsy. The seizure phenotype was a focal crisis with preserved awareness and a clonic motor onset of right-hemibody. Epilepsy surgery protocol demonstrated a left pure motor strip FCD and a full-awake resective procedure with motor brain mapping was performed. Further resection of surgical boundaries monitoring function along intraoperative motor tasks with no direct electrical stimulation corroborated by intraoperative-neuromonitorization was completed as the final part of the surgery. In the follow-up period of 3-years, the patient has an Engel-IB seizure-control with mild distal lower limb palsy and no gate compromise. LESSONS This report represents one of the few cases with pure motor strip FCD resection. In a scenario similar to this case, the authors consider that this variation can be useful to improve seizure control and the quality of life of these patients by extending the resection of a more extensive epileptogenic zone minimizing functional damage.