The current landscape of intracranial aneurysms in Africa: management outcomes, challenges, and strategies-a narrative review

Neurosurg Rev. 2023 Aug 7;46(1):194. doi: 10.1007/s10143-023-02102-4.

Abstract

Intracranial aneurysms (IAs) pose complex and potentially life-threatening challenges in Africa, where limited resources, restricted access to specialised healthcare facilities, and disparities in healthcare provision amplify the difficulties of management. Timely diagnosis and treatment are pivotal in preventing complications, including subarachnoid haemorrhage. Treatment options encompass observation, surgical clipping, endovascular coiling, and flow diversion. Positive outcomes observed in IA management in Africa include high survival rates, favourable functional outcomes, successful treatment techniques, and the absence of complications in some cases. However, negative outcomes such as postoperative complications, reduced quality of life, perioperative mortality, and the risk of recurrence persist. Challenges in IA management encompass limited access to diagnostic tools, a scarcity of specialised healthcare professionals, and an unequal distribution of services. Addressing these challenges requires interventions focused on improving access to diagnostic tools, expanding the number of trained professionals, and establishing specialised IA treatment centres. Collaboration, research, and capacity-building efforts hold significant importance in improving patient outcomes and reducing disparities in IA management across Africa.

Keywords: Africa; Global health; Global neurosurgery; Intracranial aneurysms; Low- and middle-income countries; Low-resource settings.

Publication types

  • Review

MeSH terms

  • Embolization, Therapeutic* / methods
  • Endovascular Procedures* / methods
  • Humans
  • Intracranial Aneurysm* / diagnosis
  • Intracranial Aneurysm* / surgery
  • Postoperative Complications / etiology
  • Quality of Life
  • Subarachnoid Hemorrhage* / complications
  • Treatment Outcome