Pattern of Neurosurgical Procedures in Ethiopia: Experience from Two Major Neurosurgical Centres in Addis Ababa.

Background: In Ethiopia, the number of practicing neurosurgeons is very few and the pattern of neurosurgical diseases and operations is not well known.This study was aimed to define the patterns of neurosurgical diseases and the operative procedures commonly seen at two main neurosurgical hospitals in Ethiopia.
Patients and Methods: Case records of all patients operated for neurosurgical diseases between January 2007-December 2008 (2 years period) at the Tikur Anbessa University Hospital and Myungsung Christian Medical Center were retrospectively reviewed.
Results: A total of 1364 patients were operated during the study period with M: F ratio of 1.7:1. Pediatric patients comprised 37.6% of the cases. The three top diagnosis for pediatric patients were hydrocephalus in 35.5%, neural tube defects in 27.5%, and neuro-trauma in 9.7% while neuro-trauma (28.7%) chronic subdural hematomas (22.8%) and spine and spinal cord diseases (21.2%) were the top adult neurosurgical patients. Ventriculo-peritoneal shunting (32.2%), repair of neural tube defects (27.5%) and endoscopic third ventriculostomy were the three most common operative procedures for pediatric patients and burr holes (26.8%), laminectomy &/or discectomy (17.4%), and craniotomy and tumor extirpation (15.3) were the top three procedures.
Conclusions: Different types of neurosurgical diseases are present in Ethiopia but because of lack of both diagnostic and therapeutic facilities, the operative procedures are very limited. Shortage of trained neurosurgeons makes the condition worse. This study shows that the neurosurgical training hospitals need to have improved diagnostic and therapeutic facilities.