Developing aneurysm clipping capacity in Ghana through global neurosurgical collaboration: a case series from two global brainsurgery initiative mission trips.

Introduction: The management of cerebral aneurysms in low- and middle-income countries (LMICs) faces significant barriers, including limited access to specialized neurosurgical care and equipment and dissipating human resources. Ghana's inaugural experience with cerebral aneurysm clipping, facilitated by the Global Brainsurgery Initiative (GBI), represent an attempt to address these challenges through international collaboration.

Methods: This case series details the outcomes of six patients who underwent cerebral aneurysm clipping procedures at two neurosurgical centers. These cases were done in 2023 and 2024 by a team comprising local and international neurosurgeons. After a series of virtual case discussions, patients were selected. Case load was mainly limited by logistics and operative schedules. The preoperative planning; challenges encountered and strategies for capacity building are discussed.

Results: The patients were aged 15 to 63 years, predominantly female and presented with ruptured aneurysms at the internal carotid artery terminus, posterior communicating artery, and middle cerebral artery. All patients had their aneurysms clipped. There was an intraoperative rupture in one case and perioperative rupture with subsequent infarct in another. Most patients achieved good functional recovery, with mRS scores indicating minimal to moderate disability.

Conclusion: We outline the beginnings of a new global neurosurgery partnership. The GBI mission demonstrates that with appropriate planning and collaboration, neurosurgical care in low-resource settings can achieve appreciable outcomes. Continued investment in early diagnosis, advanced treatment modalities, and healthcare infrastructure is essential for scaling access to surgical aneurysm care in Ghana.