Background:In sub-Saharan Africa, several neurosurgical diseases are rare in neurosurgical practice, in contrast to other climes. Poor diagnostic and health facilities are always blamed. More than six decades after the birth of neurosurgery in the region, those deficiencies and workforce have markedly improved in neurosciences. The aim of this study was to identify the uncommon cranial neurosurgical lesions and their frequency in the study centre.Method: Search for rare pathologies was made of prospectively recorded database of 34,670 patients managed at the centre that served a large population of about 47 million black Africans of mostly Igbo ethnicity. Results:The identified rare diseases included cavernoma (4), Moyamoya disease (0), epidermoid cysts (0), Rathke's cyst (1), chordomas (0), colloid cysts (1), pineal region tumours (4), Trigeminal Neuralgia (4), and vestibular schwannoma (5). There is no available explanation for these findings hence the importance of reporting our experience so that other researchers could make contributions. There are no previous reports on this subject from sub-Saharan Africa. Conclusion:The rarity of certain neurosurgical pathologies in the study region is a research challenge. Identification of the cause(s) could be a major scientific breakthrough in epidemiology and prevention of diseases, but this would require international collaboration.
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