Intracranial aneurysms clipping in Rwanda, can it be done? What are the challenges?

ABSTRACT

Background: Intracranial aneurysms are vascular abnormalities that cause outpouching of the arterial wall [1]. Although they are not uncommon, there is scanty information regarding intracranial aneurysms in Africa [2]. Intracranial aneurysms are often asymptomatic until they cause symptoms and signs resulting from mass compression and/ or spillage of blood products into the arachnoid space. Currently available diagnostic tools are computed tomography (CT) angiography, magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (IADSA) [1]. In our setting we continue to diagnose and achieve clipping of intracranial aneurysms amongst the currently available choices of managing intracranial aneurysms.Objectives: To establish the feasibility and reflect on the challenges of clipping intracranial aneurysms in our settings. To raise awareness among health professionals and the general population.Methods: This is a retrospective case series of 5 patients diagnosed with intracranial aneurysms at King Faisal Hospital and Kigali University Teaching Hospital from October 2014 to October 2015. Available diagnostic methods used are the computed tomography (CT) angiography and/ or magnetic resonance angiography (MRA). We have excluded cases that were diagnosed with intracranial aneurysm at autopsy.Results: Five patients met inclusion criteria for our study. We describe case by case, the choices of therapeutic measures, the challenges encountered during their management and their outcome.Conclusion: Despite the challenges, intracranial aneurysms are treatable in Rwanda with good outcome. However, there is still lack of awareness about this pathology