AONeuro Course Capetown

AONeuro holds its first Neurotrauma course on the African Continent


In January, AONeuro successfully held its first course on the African continent. Gathering together in Cape Town, South Africa, an international group of 14 AONeuro faculty experts, joining from the US, the United Kingdom, Belgium, Hungary, and South Africa, presented a comprehensive, two-day program to 38 surgeons and surgical trainees from across seven African countries. The timely course led-up to the 12th Symposium of the International Neurotrauma Society, which was held directly afterwards in Cape Town.

For the exclusive interview with Course Chair Anthony Figaji, click here

Neurotrauma around the globe
"The AO Neurotrauma course is a great initiative, and doing it for the first time on the African continent is important," explains AO international faculty member Andrew Maas from Belgium, who provided participants with a general introduction to the relevance of traumatic brain injury and neurotrauma on the first day of the course. "Most people—from policy makers to the general public—underestimate its significance. Neurotrauma is one of the leading causes of death and disability worldwide, especially in low and middle income countries," he adds.

Why neurotrauma management is needed in Africa
"It is in Africa, India, China, and Latin America where the trauma burden is heaviest," shares AONeuro course director Tony Figaji. "In Africa, road traffic accidents are the main cause of trauma, with young adult males being the primary victims," the native South African adds. "The majority of these deaths are due to head injuries. And while trauma injuries are prevalent, most of the funding on the continent is allocated to infectious diseases, making trauma a silent epidemic," he explains.

Providing practical instruction on the ground
"With the AONeuro course, we aim to equip delegates with practical skills in managing neurotraumas, so that they know what to do at two o'clock in the morning, when a patient comes in with cranial swelling," Figaji shares. "While everyone may not have the same resources to work with, what is key is to provide insight on the important issues when it comes to managing patients. With head injuries, there is a huge amount of heterogeneity, and through case discussions and lectures, things can be discussed in a group setting that one doesn't find in a textbook. There is nothing quite the same as sitting in a room, listening to an expert explain how he or she would manage a particular situation, and then having the opportunity to also ask questions," he conveys.

During the course, the notable faculty members exchanged learnings and experiences on topics ranging from cranial fossa repairs, endoscopic transnasal approaches, and cranioplasties, to the penetrating injuries from gunshot and knife/blade wounds, and the management of arterial injuries and bifrontal contusions. The course also discussed multimodal monitoring, craniotomy surgical planning, and issues specific to pediatric neurotraumas. A session was also given on whether ICP monitoring is needed in severe traumatic brain injury. Hands-on practical sessions covered posterior fossa decompression and cranioplasty techniques, as well as ventrioculostomy, bolt and monitor insertion, and decompressive craniectomies (hemicraniectomy and bifrontal).

Tips were also given on what to prioritize when developing a neurocritical care unit with limited funding.

Course feedback—"potentially practice altering"
For the participants, the course was a great success, providing a solid theoretical basis and practical principles of managing neurotrauma, covering emergency and planned procedures, complications, and reconstructive surgery.

"Many points presented were potentially practice altering," shared one participant, while another stated that "valuable knowledge was gained from experienced faculty for treating and managing patients." Course ratings were very high, with many delegates stating that the course "more than fulfilled expectations."

Norman Fisher-Jeffes, an AOSpine faculty member based in South Africa who attended the neurocourse as a delegate, shared: "The neurotrauma course was excellent and should be expanded. It would be ideal to create a situation where treatment for a specific clinical problem can be debated using various resource options."

Everyone involved found the course equally successful. The course provided an ideal faculty-delegate ratio, and was well-balanced in providing lectures as well as opportunities for delegates and faculty to interact during sessions or over coffee. It also showcased the possibilities that are available for improving trauma care on the ground in Africa.

Watch the Video with statements of Course participants

Developing a new cadre of neurotrauma professionals
"The single most important thing we need to do is to find ways to get education going in Africa, to improve the treatment of head trauma in a place where it is one of the major causes of morbidity and mortality," shares Graham Fieggen, national faculty member and President of the Continental Association of African Neurosurgery. "Neurosurgeon experts have already been identified in Egypt, Sudan, Kenya, Ethiopia, Nigeria, Ghana, and Algeria, who, with a little bit of support and mentoring, could very well become AO faculty, creating a new cadre of highly-educated neurotrama professionals across the continent," he offers.