Background: This study looks at how COVID-19 affected the admission and training of neurosurgical residents worldwide. Methods: From 2019 to 2021, we reviewed multiple databases (i.e., Google Scholar, Science Direct, PubMed, and Hinari) to evaluate the impact of the COVID-19 pandemic on neurosurgery resident training and admission in low middle-income countries (LMICs) and high-income countries (HICs). We then utilized a Wilcoxon signed-rank test to evaluate the difference between the two LMIC/HICs and employed Levene’s test to assess the homogeneity of variances. Results: There were 58 studies that met our inclusion criteria; 48 (72.4%) were conducted in HIC and 16 (27.6%) in LMIC. The admission of new residents was mostly canceled in HIC (31.7%; n = 13) and in LMIC (25%; n = 4) from 2019 to 2021 due to COVID-19. Learning modalities changed to include predominantly video conferencing (i.e., 94.7% [n = 54] of cases). Further, neurosurgery was largely restricted to emergency cases alone (79.6% [n = 39]), with only 12.2% (n = 6) elective cases. The result was a marked reduction in resident surgical training (i.e., 66.7% [n = 10] in LMIC and 62.9% [n = 22] in HIC), despite increased workloads in (i.e., LMIC [37.4%; n = 6] and HIC [35.7%; n = 15]). This was attributed to the marked reduction in the number of surgical patients allotted to each resident (i.e., LMIC [87.5%; n = 14] than HIC [83.3%; n = 35]). Conclusion: The COVID-19 pandemic markedly disrupted neurosurgical education globally. Although differences have been found between LMICs and HICs training, the reduction of neurosurgical case-loads and surgical procedures has significantly impacted neurosurgical training. The question remains, how can this “loss of experience” be redressed in the future?

Background Epidural hematoma constitutes a common condition in neuro-traumatology. If its acute form is well known, the chronic one remains less described. Objective This study aimed to evaluate the epidemiology, clinical presentations, management, and outcomes of chronic epidural hematoma. Methodology Systematic searches of PubMed, Google Scholar, and ScienceDirect were performed from a database searching for all studies reporting chronic epidural hematoma. Pooled statistics were calculated using measures of central tendency and spread. The rank correlation test and the regression test, using the standard error of the observed outcomes as predictor, are used to check for funnel plot asymmetry. Results A total of 3009 studies were identified, of which 95 were included with 359 patients. Chronic epidural hematoma (CEDH) was more common at the intracranial level than spinal level (91.9% vs 8.1%). The average age of onset was 37.2 ± 4.83 years. The common cause found was trauma (n = 279; 77.72%) with 271 (97.1%) cases for the head and 8 (2.9%) cases for the spine. The mean delay between the trauma and the first symptoms was 13.32 ± 1.73 days in intracranial level and 16.38 ± 2.49 days in spinal level. CT scan constituted the main diagnosis tool. The lesion was predominantly located in the temporal region at the intracranial level and lumbar region at the spinal level. Craniotomy and laminectomy constituted the most reported treatment option, respectively, at the intracranial and spinal level. The outcome was commonly uneventful. Correlation and regression tests for publication bias assessment show no significant funnel plot asymmetry with high p value (p = 0.8458 and p = 0.9596, respectively). Conclusion CEDH was commonly related to trauma. Its treatment was mostly surgical at both sites.