Surg Neurol
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Case Reports
Cervical myelocystocele with Chiari II malformation: magnetic resonance imaging and surgical treatment.
The myelocystocele is a rare clinical entity, and there have only been six case reports concerning the cervical myelocystocele, including ours. ⋯ In cases of cervical myelocystocele with Chiari II malformation, untethering through intradural exploration to treat the tethered cord and outer decompression of the foramen magnum are needed. MR imaging is the best modality for preoperative determination of anatomic relationships.
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A survey conducted among African neurosurgeons shows that there are now 500 neurosurgeons in Africa; that is, one neurosurgeon for 1,350,000 inhabitants, and 70,000 km2. The distribution of these neurosurgeons shows a striking regional disparity: North Africa has 354 neurosurgeons for 119 million inhabitants; that is, one neurosurgeon for 338,000 inhabitants; and South Africa has 65 neurosurgeons for 40 million inhabitants; that is, one neurosurgeon for 620,000 inhabitants. Between these two areas where neurosurgery is developing quite well, we have the majority of African countries with a scant density of neurosurgeons (81 neurosurgeons for 515 million inhabitants; that is, one neurosurgeon for 6,368,000 inhabitants). ⋯ However, the real factor of optimism is the African neurosurgeons who should promote neurosurgery in their continent, at the level of their own countries by developing information and health education, setting their specialty in the education syllabus and health planning, and settling into active and performing societies. At the continental and international level, African neurosurgeons should institutionalize inter-African cooperation, expedite their continental association (PAANS), and further exchanges with the other continents through the WFNS. The latter, together with other associations such as the European Association of Neurosurgical Societies (EANS) could provide help to the development of neurosurgery in Africa as far as training, exchanges, research, and organization are concerned.