Brain tumor surgery: including Cases reflecting Challenges and Outcome during War

Background: In view of fact, the drawback of the armed conflict between Sudanese army and rapid support force was shocking, mass migration to neighboring countries, and many civilian were died, behind the war there were another factors for death, among these factors is brain tumors. The objectives of this study: To build up information and correlation between demographic data, brain tumors, surgery type and limitation of surgical resources, and to identify neurosurgical practice during armed conflict and how surgical resources can be utilized. Methods: This was a case report study, done at Almubarik hospital from April 2024 to July 2024.Ethical approval was taken from the National Center for Neurological Sciences.The operating room at Almubarik hospital includes X-ray viewing box, operating table, which is design for obstetrical and gynecology operation. very limited instruments for completing the surgery (forceps, straight dissector and scissors).Moreover, regarding anesthesia in this new situation there is no invasive BP, CVP, core temperature or even capnograph, all this made difficulties in monitoring the patient. In this conflict period, due to the lake of monitoring of the drugs and inappropriate storage, we used to give IV propofol , midasolam , morphine , lidocaine and nondepolrising muscle relaxant. ETT size 7 for all adult patients as it is the only big size available. Halothane MAC was used as volatile agent with propofol. pracetamol , magnisum sulphate ,are given as analgesia.Nevertheless,, for positing we manipulate our operating table by adding special head rest which was manually made from iron par and semi firm bellows are constructed on it tightly, so prone position was made. Conclusion: Despite of the infrastructural limitations, brain tumor surgery has special nature in the context of this conflict. Brain tumor surgery is challenges, and need not only skillful neurosurgeon but advance technology and well trained staff.