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Background: Despite global efforts to improve surgical care access, many low- and middle-income countries, especially in neurosurgery, face significant shortages. The Gambia exemplifies this, with only 1 fully qualified neurosurgeon serving its population of 2.5 million people. This scarcity results in higher morbidity and mortality., Objective: We aim to document the history and current state of neurosurgery in the Gambia to raise awareness and promote neurosurgery development., Methods: The study reviews the Gambia's health care system, infrastructure, neurosurgical history, workforce, disease burden, and progress, with information derived from reference sources as well as author experience and interviews with key partners in Gambian health care., Results: Neurosurgery in the Gambia began in the 1970s, facing constraints due to competing health care demands. Significant progress occurred much later in the early 2010s, marked by the initiation of Banjul Neuro Missions and the establishment of a dedicated neurosurgery unit. We report significant progress with neurosurgical interventions in the past few years showcasing the unit's dedication to advancing neurosurgical care in the Gambia. However, challenges persist, including a lack of trained neurosurgeons, equipment shortages such as ventilators and diagnostic imaging. Financial barriers for patients, particularly related to the costs of computer tomography scans, pose significant hurdles, impacting the timely diagnosis and intervention for neurological conditions., Conclusions: Neurosurgery in the Gambia is progressing, but challenges like equipment scarcity hinder further progress. We emphasize the need for addressing cost barriers, improving infrastructure, and fostering research. Engaging the government and international collaborations are vital for sustained development in Gambian neurosurgery., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: In sub-Saharan Africa, the management of ruptured intracranial aneurysms (RIAs) is difficult for many reasons. In this retrospective, 3-year study, the authors will demonstrate the particularities of the management of RIAs in Senegal., Methods: We analyzed retrospectively 102 consecutive cases of RIAs operated on between May 2013 and December 2016 in Neurosurgical Department of Fann Hospital in Dakar, Senegal. Patients characteristics, imaging results, aneurysms, treatment, and outcome were analyzed., Results: One hundred two cases were operated in this 3-year period of a total of 129 cases of RIAs received in our department in the same period. A total of 65% of the patients were female. According to the World Federation of Neurosurgical Societies (WFNS) scale, 49% were WFNS I, and 33% WFNS III. Fisher scale showed 29% of Fisher 2 and 45% of Fisher 4. The aneurysms were located on anterior communicating complex in 38%, on the internal carotid artery in 28%, on the middle cerebral artery in 27% of cases and on posterior circulation in 9 cases. The pterional approach was used in 93 cases. According to the modified Rankin Scale, 67 patients (65.6%) had good outcome, 22 (21.5%) had poor outcome, and the mortality rate was 12.7% (13 patients) at last follow-up., Conclusions: This study demonstrates encouraging results if one refers to the global patient postoperative outcomes. However, the large number of patients not undergoing treatment also requires us to improve preoperative management conditions., (Copyright © 2017 Elsevier Inc. All rights reserved.)