Neuronavigation-guided brain surgery - A retrospective case series from Malawi (2022-2025)

Area of Science:

• Neurosurgery
• Medical Technology
• Global Health

Background:

• Neuronavigation (NN) enhances precision and safety in intracranial procedures.
• Limited data exists on NN utilization in Low- and Middle-Income Countries (LMICs), especially in Sub-Saharan Africa (SSA).
• This study addresses the gap by examining NN use in Malawi.

Purpose of the Study:

• To describe patient demographics, surgical indications, and interventions using NN in Malawi.
• To evaluate the feasibility and early outcomes of NN-guided neurosurgery in a low-resource setting.

Main Methods:

• Retrospective review of NN-guided cranial surgeries at Queen Elizabeth Central Hospital, Malawi (Jan 2022 - Apr 2025).
• Data collected: demographics, diagnosis, intervention type, and outcomes (discharge status, complications, one-month survival).
• Analysis focused on in-hospital and early postoperative periods due to limited follow-up.

Main Results:

• 117 patients underwent NN-guided cranial procedures; 80.3% were for tumor resection.
• At one month, 48.7% of patients were alive, with 22.2% mortality and 25.6% experiencing poor outcomes.
• Successful implementation of NN was demonstrated, with tumor resection being the primary indication.

Conclusions:

• Neuronavigation (NN) has been successfully implemented in a tertiary hospital in Malawi.
• Tumor resection was the predominant surgical indication for NN-guided procedures.
• Early outcomes support the feasibility and clinical value of NN in low-resource settings.