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Pediatric head injury is common in our environment and occurs mostly due to fall from heights, but motor vehicle accidents cause the severest form of injury. Child abuse is increasingly becoming recognized as a cause of pediatric head injury. Management is multidisciplinary. Prompt resuscitation and cervical spine protection are key to survival. Scalp bleeding may easily cause anaemia because of small intravascular volume. The post-resuscitation Glasgow Coma Scale score is an important prognostic factor. Intracranial haematomas should be aggressively managed. Education and enforcement of legislation on vehicle safety rules are important in preventive strategies. Pediatric spinal cord injury presents an enormous challenge, not only to the neurosurgeon but also to the health and economic resources of any nation. The care of the spinally disabled child is far from ideal in our environment. Late presentation is the rule in most African settings, precluding those who would have benefitted from the institution of early treatment modalities. Prompt resuscitation and optimal fluid administration limit further cord injury. Personnel, facilities and dedicated centres for spinal care are scarce, needing urgent attention.

Brain and spinal cord tumours are increasingly being diagnosed in Africa and other developing countries as more centres acquire more sophisticated and less invasive diagnostic facilities. Improvement in the number and expertise of medical personnel also plays a significant role. In addition, advances in anaesthesia and surgical techniques have allowed for increased survival of children with these otherwise dismal clinical conditions. However, the situation in Africa is still far from the ideal that is obtained in the developed nations because only very few centres have the facilities and manpower to manage these conditions. Even in developed centres, however, the poor prognoses of some tumour types have not changed despite all the advances [1].