World Neurosurg
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The objective of the study was to identify the predictors of improved third cranial nerve (CN III) function in patients who underwent surgical clipping for posterior communicating artery (PComA) aneurysms with varying degrees of CN III palsy at presentation. ⋯ Surgical clipping of the PComA aneurysm in patients with CN III palsy results in improvement of the CN III function in the majority of patients. The type of the CN III palsy at admission (complete/partial) is a significant predictor of complete improvement in CN III function.
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Two major challenges facing African neurosurgery include quality and quantity, in both recourses and personnel. Discrepancy is noted between the two poles, namely, the north and south of the continent and the sub-Saharan area. Although reasonably advanced in the north and south, neurosurgery remains poorly distributed and has multiple deficiencies. ⋯ Insufficient state funding and research facilities aggravate the situation and discourage the few well-trained African neurosurgeons to practice in their homeland. For those who do return home, cultural, social, economical, and political issues hinder their performance and hence the quality of neurosurgery delivered in Africa. Strategies for rectification of these handicaps are presented, including the need for high-standard local training and support from international organizations.
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Neurosurgery, in one form or another, has a long tradition in Kenya. Early skull trepanations in Kenya were reported by previous studies, which reveal that these procedures have a long tradition, being passed down from generation to generation. Modern neurosurgical development in Kenya has its origins in the late 1940s when the first elective neurosurgical procedures were performed by Dr. ⋯ Formal neurosurgery developed from these initial steps, with the arrival of the first trained specialist, Dr. Renato Ruberti, whose pioneering efforts resulted in the founding of the Neurological Society of Kenya (NSK), the Pan African Association of Neurological Sciences (PAANS), and the African Federation of Neurosurgical Societies (AFNS). The last quarter of the 20th century has seen the progress of neurosurgery reach its present respectable levels, with dedicated and well-trained Kenyan neurosurgical specialists focusing not only on its practice but diligently pursuing its development.