The Patients’ Path to Surgery and Limited Imaging Armamentarium

The present chapter is a bridge between Chaps. 5 and 7 . Chapter 5 describes in general some obstacles, which have to be faced establishing a cerebrovascular fellowship program in central Africa in general, and Chap. 7 describes specific cases. In the present chapter, we describe the path of the patient with a cerebrovascular disease from home to hospital. The patients are seen in one of the nationwide hospitals, and a CT is performed and then referred to the reference hospital. After discussing the case, an appointment will be arranged for microsurgical clipping for the time the expert cerebrovascular surgeon will be in the country. Until then the patient is facing an increasing risk of rebleeding. As soon as the local neurosurgeons are fully trained, this waiting time for the expert to travel from a developed country will be obsolete. The local neurosurgeons will be able to take over the case and not risking a rebleeding of the aneurysms.