Evidence map›Paper›PMID 41321765›Full record

ArticleBrain & spine2025

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

Ahmad Alali, Yollam Makanjira, Leonard Chafewa, Davis Mpando, Zico Mianyen, Oday Atallah, Ralph König, Thomas Kapapa, Patrick Kamalo

Abstract read
In one paragraph

Article in Brain & spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Understanding barriers to pediatric hydrocephalus management: an international survey.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ahmad AlaliDepartment of Neurosurgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Yollam MakanjiraBlantyre Institute of Neurosurgical Sciences, Chipatala Avenue, P O Box 1052, Blantyre, Malawi.
Leonard ChafewaBlantyre Institute of Neurosurgical Sciences, Chipatala Avenue, P O Box 1052, Blantyre, Malawi.
Davis MpandoBlantyre Institute of Neurosurgical Sciences, Chipatala Avenue, P O Box 1052, Blantyre, Malawi.
Zico MianyenBlantyre Institute of Neurosurgical Sciences, Chipatala Avenue, P O Box 1052, Blantyre, Malawi.
Oday AtallahDepartment of Neurosurgery, University of Oldenburg, Steinweg 13-17, 26122, Oldenburg, Germany.
Ralph KönigDepartment of Neurosurgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Thomas KapapaDepartment of Neurosurgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Patrick KamaloBlantyre Institute of Neurosurgical Sciences, Chipatala Avenue, P O Box 1052, Blantyre, Malawi.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Neuronavigation (NN) has become an essential tool in modern neurosurgery, enabling more precise and safer intracranial procedures. While its use is well-documented in high-income settings, there are limited data from Low- and middle-income countries (LMICs), particularly in Sub-Saharan Africa (SSA). This study presents a retrospective case series of NN-guided neurosurgical procedures performed in Malawi, aiming to describe the patient demographics, surgical indications, and interventions over a three-year period. Methods: We conducted a retrospective review of all patients who underwent NN-guided cranial surgery at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, between January 2022 and April 2025. Data collected included demographics, diagnosis, intervention type, and outcomes. Outcomes were assessed from discharge status, postoperative complications, and one-month survival. Due to limited follow-up, analysis was restricted to in-hospital and early postoperative periods. Results: 117 patients underwent NN-guided cranial procedures; 52 (44.4 %) were female. The most common procedure was craniotomy for tumor resection (94; 80.3 %). Other procedures included open biopsy (7; 6.0 %), stereotactic biopsy (7; 6.0 %), cerebral abscess drainage (4; 3.4 %), bone tumor excision (2; 1.7 %), intracranial cyst fenestration (1; 0.9 %), endoscopic third ventriculostomy (ETV) (1; 0.9 %), and scalp mass excision (1; 0.9 %). At one month, 57/117 (48.7 %) were alive; 26/117 (22.2 %) died, 3/117 (2.6 %) were discharged palliatively, and 1/117 (0.9 %) had a complication. Overall, 30/117 (25.6 %) experienced a poor outcome, this group includes the 26 deaths, the 3 palliative discharges, and the 1 postoperative complication. Conclusion: NN-guided cranial surgery was successfully implemented at a tertiary hospital in Malawi, with tumor resection as the predominant indication. Early outcomes were encouraging, supporting NN's feasibility and clinical value in low-resource settings.

Indexed as

Cranial surgeryLow-resource settingsMalawiNeuronavigationNeurosurgeryTumor resection

Identifiers

PMID41321765
PMCPMC12657380

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.