World Neurosurg
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Africa has an increased burden of neurosurgical diseases with an estimate of 1,986,392 neurosurgical cases, 108,824 neurosurgical case capacity, and 1,877,568 case deficits yearly. Literature suggests that about 8420 neurosurgeons are needed to fill this vast gap. The main objective of this study is to elucidate barriers encountered in pursuing neurosurgery training in the African context. ⋯ Even with its robust population growth, Africa is not producing enough neurosurgeons to meet the demands of the population due to several barriers. Delineating these challenges and barriers represents an important step in developing sustainable mechanisms for recruitment, training, mentorship, and support of burgeoning African neurosurgeons.
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Africa bears more than 15% of the global burden of neurosurgical disease; however, it has the lowest neurosurgical workforce density worldwide. The past decade has seen an increase in neurosurgery residency programs on the continent. It is unclear how these residency programs are similar or viable. This study highlights the current status and interdepartmental and regional differences, with the main objective of offering a template for improving the provision of neurosurgical education on the continent. ⋯ There are significant differences in the African postgraduate neurosurgical education curriculum warranting standardization. This study identifies areas of improvement for neurosurgical education in Africa.
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Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children. In Nigeria, there is paucity of information about TBI in children. We describe the profile of pediatric TBI in a university hospital in South-West Nigeria. ⋯ Children account for a large number of TBIs in our environment, which are mostly from road traffic crashes and falls. Only a few received computed tomography scan of the brain. Most cases had nonoperative care, and outcomes are worse with increasing severity of head injury. Specific preventive measures need to be formulated and/or enforced by governments at all levels.
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Brainstem cavernous malformations account for 15%-18% of all central nervous system cavernomas and are histologically characterized by thin-walled, low-pressure capillaries, classically without intervening brain tissue.1,2 Cavernomas may be sporadic, typically characterized by a single lesion, or inherited. The inherited form is most often autosomal dominant with incomplete penetrance and variable expression. ⋯ We demonstrate the exoscope's unparalleled visualization of the anterolateral brainstem, with nominal condylar drilling. The patient and his parents consented to the procedure and publication.
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The objective of this study was to compare the effectiveness and safety of local anesthesia (LA) and epidural anesthesia (EA) for percutaneous transforaminal endoscopic discectomy (PTED) and provide reference data for clinical decision-making. ⋯ EA is as safe as LA and produces better anesthetic effects than LA in patients undergoing PTED. Therefore, EA should be promoted as a reliable anesthetic technique for PTED.