AANS Neurosurgeon | Volume 26, Number 3, 2017

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Neuroscience and Neurosurgery in Bosnia-Herzegovina

Bosnia and Herzegovina is a country with an approximate area of 51 thousand km² for a population of 3.8 million and is middle-developed country (1). Neuroscience, as a separate area of science in this country, is not well developed. It had been seen as a branch of biology but is currently an interdisciplinary science that collaborates with other fields, such as medicine, (primarily neurology and neurosurgery), chemistry, computer science, engineering, genetics and allied disciplines.

The scope of neuroscience has broadened in the last couple of years and now includes different approaches used to study the molecular, cellular, functional and medical aspects of the nervous system. The techniques used by neuroscientists have also expanded enormously from molecular and cellular to neuroimaging. Recent theoretical advances in neuroscience have also been aided by the study of neural networks through cooperation between medical doctors and engineers. However, the most prominent area is still clinical neuroscience that consists of medical specialties such as neurology, neurosurgery and psychiatry.

Prof. Zdravko Besarovic

Looking into the history of neurosurgery, we can say that the first brain operation using neurosurgical techniques in Bosnia and Herzegovina was officialy performed a relatively long time ago in a hospital named Vakufska Bolnica in Sarajevo in 1891. There were three operations consisting of a craniotomy, removing bone fragments and closing the dura, which resulted in epileptic fits being cured or ceasing to exist. All three operations were performed by Dr. Karl Bayer (2,3).

Despite this very early beginning, the first independent neurosurgery unit in Bosnia and Herzegovina was established in 1970 by Professor Zdravko Besarovic and experienced its peak under the leadership of Prof. Faruk Konjhodžic, both pictured, who laid the foundations of modern neurosurgery (4).

Prof. Faruk Konjhodzic

Today, there are seven neurosurgical departments in the country, which routinely perform almost all neurosurgical procedures. These include operations in the field of general neurosurgery with complex neurotrauma, neuro-oncology, cerebrovascular surgery, skull base and pituitary surgery, complex spine surgery, pediatric neurosurgery, functional neurosurgery, peripheral nerve surgery, epilepsy, classic and frameless stereotactic neurosurgery, endoscopic neurosurgery and neurosurgical intensive management. The number of operations is increasing significantly every year. If we analyze the qualitative aspects of operations during the past few years, there is a trend of increasing complex operations and the introduction of new sophisticated and professionally demanding operative techniques.

A very motivated and well-trained staff, many having spent part of their training in recognized international centers, are working to ensure the development of neurosurgery in Bosnia and Herzegovina. Special emphasis is being placed on the development of young neurosurgeons through a well-conceived, six-year neurosurgical training program. During the program, the trainee is required to pass 30 partly oral exams and demonstrate the corresponding surgical technique in the operating room. The final neurosurgical exam has two parts. The first part is a multiple-choice exam followed by an oral exam performed by a three-person board appointed by the National Ministry of Health. International experts are sometimes included on this board (5).

Further developments in neuroscience and neurosurgery in Bosnia and Herzegovina, including the improvement of staff morale and programs, depend on the economic power of the country and the characteristics of the higher education system that are in the midst of serious changes. Our success will also depend on good international connections and collaborations on current scientific projects with other countries in the region.

References
1. Atlas Country Resources for Neurological Disorders: World Health Organization, Geneva. (2004). World Federation of Neurology, London.

2. Besarovic, Z., Konjhodžic, F., Custovic, K., & Kadic, N. (1978). Neurosurgery in Bosnia and Herzegovina. Med Arh 32:381-4.

3. Konjhodžic, F. (2006). 115 Years since the First Brain Operation in Bosnia and Herzegovina. Acta Medica Academica.

4. Omerhodžic, I. & Mašic I. (2006). Department of neurosurgery, Clinical center University of Sarajevo: Brief history and current achivements. Materia socio medica.

5. Omerhodžic, I., Tonge, M., Matos, B., Musabeliu, E., Raspanti, C., Ferdinandov, D., Galimova, R, …. Kursumovic, A. (2012). Neurosurgical Training Programme in Selected European Countries: From the Young Neurosurgeons’ Point of View. Turkish Neurosurgery.

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