AFRICAN NEUROSURGERY .1. HISTORICAL OUTLI NE

This outline of the history of African Neurosurgery explains the role that North Africa has played in the Middle Ages in the development of Neurosurgery, the origins of the development of the latter in the twen tieth century, and the delay that African Neurosurgery still shows at the present time in the majority of African countries. On the papyrus of the pharaonic era, we have found the description of some neurosurgi cal procedures such as trephination and brain aspiration by a transphe noidal approach used before mummification. It is particularly trephina tion which summarizes the ancient history of African neurosurgery, as it was widely used throught the continent, practised and taught by hea lers in African tribes. The technical concepts of trephination are bas ed, to a great extent, on the descriptions of Arab physicians of the M iddle Ages. It was at that time (Middle Ages) that several Arab physic ians such as Avicenne, Rhazes, and Avenzhoer described many types of n ervous system diseases and the techniques to treat them. But it was ma inly Abulkassim Al Zahraoui (Abulkassis) who was the pioneer of neuros urgery as he devoted one volume of his treatise (made up of 30 volumes ) to neurosurgery, a precise description of many aspects of neurosurgi cal pathology, its treatment, instruments and neurosurgical techniques . We have reported in this article five original extracts in Arabic wh ich deal with skull fractures and their treatment, vertebro-medullary traumas and their treatment, hydrocephalus and its treatment, tumors o f the skull vault and their treatment, and finally the basic knowledge of anatomy which is of great interest for a surgeon. The medical know ledge of that time which gave birth to medical schools and hospitals w as transmitted progressively to Europe and played an important role in the development of medicine during the European Renaissance in the fi fteenth and sixteenth centuries. During colonization, neurosurgical pr actice started and developed in many African countries, together with the development of the health system that the colonial forces initiate d in general as soon as they had come to these countries. This neurosu rgery practised in the departments of general surgery either by neuros urgeons or general surgeons took part in the birth and development of neurosurgery as an independent specialty, thanks to the combined effor ts of some European and African pioneers. Modern neurosurgery was intr oduced and started to develop in African countries from 1960, and the teaching of this specialty in many African universities began between 1960 and 1970.