Prof. Munir Elias

THIS NEUROSURGICAL SITE IS MULTILINGUAL IN  HOMEPAGE BUT THE WHOLE WEBSITE IS IN ENGLISH

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IN THE MEMORY OF MY GREAT TEACHER

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Ceiling suspended full option Carl Ziess Pentero C microscope

NEUROSURGERY

This site is directed mainly to the medical audience and neurosurgeons, partially aimed to present the operative and academic activities of Prof. Munir A. Elias Shawash over 33 years period. Here the neurosurgeon can find the standards and new modifications in the treatment strategies in paraplegia, brain tumor, spinal cord injuries, head injury, pain management strategies, including neuralgia of different etiologies, movement disorders. Neurosurgeon needs a very long way to understand that, experience is important in this field of medicine - neurosurgery.
Stroke and ruptured arterial aneurysms remain in the upper list of difficult problems, which are far from perfection and the mortality rate remains high. Spinal surgery is extensive and take 80% of the neurosurgical activities: prolapsed disc , lumbar, cervical and dorsal are the top ranking in practice followed by other degenerative spine problems, such as spondylolisthesis, OPLL with cervical and lumbar canal stenosis.
Neurosurgery has time-sensitive decision-making strategies. This is governed by the rapidly changing status of the patient. Neurosurgeon must react accordingly to the recent moment. He must be able to predict, or at least to keep in mind the possible complications, and react with caution to prevent them, before they escalate. Intraoperative video documentation made it possible to analyze and retrospectively discover some causes of complications, which the neurosurgeon previously blamed himself for that. It became clear, that some triggering factors for complications are presenting before their eminence.
Here come the power of intraoperative monitoring using IOM ISIS HighLine 32 channel with all available parameters, which can alarm the functional shifts before they become real disaster and to take the appropriate measures before they become irreversible.
Neuroanesthesia is the cornerstone in proper navigation of such monitoring to make it feasible and to guide the patient with safe margins until he pass the surgical storm. It starts from the preoperative period until the patient is no more complaining, whatsoever it needs time.
Intraoperative morphological navigation using BrainLab skyvision with the MRI with the most high standards available with all softwares more empower the surgeon to know and see all the data and take the proper action and know at which stage he is standing.
Pentero-C is not only a microscope, it give the neurosurgeon the power to see, what he could not see before with the appropriate softwares.
Concerning stemcell therapy, it got excellent results in all disciplines, where tissue have good regenerative potential with primitive biological function. In central nervous system, which consist of neurons and supportive tissues, the glial tissues can regenerate, but their role in final higher functions is somehow limited. Treatment of paraplegia and stokes are still far from perfection. The tried surgical treatment of paraplegia with putting anastamoses between the upper dorsal functioning roots and lower lumbar non-functioning roots gave bad results. It seems resolving such problems must have other dimensions or combination of them.
Not all new standards in neurosurgery can stand time. Only the good for the patient's outcome will stand and remain even, if they are too old.
The last years at Shmaisani hospital functional neurophysiologic navigation ISIS Inomed Highline 32 channels and BrainLab Suite integrated with Siemens Skyra 3 tesla fMRI with fibertraking (DTI) and other more than 80 Syngo softwares for intraoperative monitoring are in practice.
It is very sad to say that, very huge medical corporations can misinform the neurosurgeon about the new products without telling that these items having disadvantages, but in the contrary, reporting that no morbidity or complications can arise, until the neurosurgeon discover them in his personal experience. Profit-oriented corporations must respect the ethics and tell the true story about any product, so as, at least to be ready to inform the patient and to try to resolve these possible complications.
When you have one complication, you forget the hundreds of successful alike surgeries and a sad feeling will overwhelm you, not mentioning that when you live in the third world, where no body understand this, including the primitive wrong directed legal system. 
With the introduction of new technologies, new dimensions arise and new problems also. When you have more data, you have more information to deal with and your tactics and options also may expand further, but despite that, complications will remain and they will need solutions. At last we are human beings and the more effort you do, the more spirit comfort you will feel when your life come to end.


 

Magnetom Skyra 3 tesla in action.

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.

 

Inomed ISIS 32 channel Highline Functional Neuronavigtion.

Inomed ISIS IOM highline with 32 channel and Neuroexplorer version 4.2 is functioning for several months, starting from 01-August-2007. For more detailed information about this functional neuronavigation machine with its early alarming signals, please refer to inomed.com

Prestige LP Artificial cervical disc.

Prestige LP Cervical Disc system Medtronic.

ISIS MER for DBS and lesioning

Neurostimulation with ISIS Inomed system.

 mailto: me@neurosurgery.me ** SITE MAP **

 

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad documentation.


After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

OPERATIVE VIDEO GALLERY
TO SEE YOUR OPERATION
CLICK HERE!

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns.clinic
cns-online.com
cns.nu
cns.surgery
cns.today
e-neurosurgery.com
neurosurgery.ag
neurosurgery.bz
neurosurgery.co
neurosurgery.cz
neurosurgery.fr
neurosurgery.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips
neurosurgery.tv
neurosurgery.tw
neurosurgeryspine.org
skullbase.surgery
spine.surgery

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
neurosurgicalencyclopedia.net
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
craniopharyngiomas.net
ependymomas.com
ependymomas.net
glioma.co
gliomas.info
glioma.ws
meningiomas.info
meningiomas.org
neurooncology.me
neurooncology.tv
neurooncology.ws
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com
pituitaryadenoma.net
schwannomas.com
theneuro-oncology.com

Neuroanatomical Sites
diencephalon.info
diencephalon.org
humanneuroanatomy.com
medullaoblongata.info
mesencephalon.org
microneuroanatomy.com

Neuroanesthesia Sites
neuroanesthesia.info

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com
neurophysiology.ws

Neuroradiological Sites
e-neuroradiology.com
neuroradiology.ws

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

Personal Sites
cns-clinic.net
cnsclinic.org
munirelias.com
munir.ws

Spine Surgery Sites
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.co
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com

** PLEASE DESCRIBE THIS IMAGE ** Amyotrophic lateral sclerosis.
** PLEASE DESCRIBE THIS IMAGE ** Anterior & lateral spinal cysts
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Arnold-Chiari malformation
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Autoreferat
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Avoidance of cosmetic deformity in petroclival approaches
** PLEASE DESCRIBE THIS IMAGE ** Bad surgeon-Bad result with unimaginable complications.
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Basics in metastatic brain tumors 
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Brown-Sequard syndrome due to PCD C5-6
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Cervical discectomy-new concepts
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Cervical Partial Coporectomy
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Cervical Spondylosis
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Congenital torticollis
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Discectomy prolapsed lumbar disc
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Drilling help minimize surgical trauma during flavotomy
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First authority to remember.
** PLEASE DESCRIBE THIS IMAGE ** Funny medicine.
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ENT Induced complications
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Extensive glomus jugulare resection & facial anastamosis direct from the brainstem
** PLEASE DESCRIBE THIS IMAGE ** Gliadel wafers, radiation, temozolomide, Avastin and CAMPTO in treating glioblastoma multiforme.
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Hemangioblastoma
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Highly malignant endocrine carcinoma mimicking posterior clinoid meningioma
** PLEASE DESCRIBE THIS IMAGE ** Human Prion Diseases
** PLEASE DESCRIBE THIS IMAGE ** Intraoperative CVA of the left cerebral hemisphere during discectomy for PCD C4-5 and C5-6 with fusion.
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Intraspinal cysts
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Isthmic spondylolisthesis
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List of neurosurgical operations performed by the author during 1980-1996 
** PLEASE DESCRIBE THIS IMAGE ** List of scientific articles performed by the author during 1080-1998
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Lost battle.
** PLEASE DESCRIBE THIS IMAGE ** Medulloblastoma
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Metastatic brain tumors
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Modified osteoplastic midline suboccipital approach

** PLEASE DESCRIBE THIS IMAGE ** MultiHans - Bracco induced anaphylactic shock
** PLEASE DESCRIBE THIS IMAGE ** Neurenteric Cyst -Case Report
** PLEASE DESCRIBE THIS IMAGE ** Neurodegenerative Disease and MRSpectroscopy.
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New method in cubital tunnel release.
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Old established standards of carpal tunnel release.
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Optic chiasm glioma
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Ossification of Posterior Longitudinal Ligament.
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Paragangliomas
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Paraplegia
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Paraplegia discussion 
** PLEASE DESCRIBE THIS IMAGE ** PEEK Satellite Nucleus replacement sphere
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Prestige LP cervical disc system
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Prolapsed dorsal disc
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Recurrent prolapsed lumbar disc
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Sacrococcygeal chordoma.
** PLEASE DESCRIBE THIS IMAGE ** Scoliosis
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Single metastatic brain tumors
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Spontaneous intracranial hemorrhage.
** PLEASE DESCRIBE THIS IMAGE ** Stem cell therapy results.
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Syringomeylia
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Tethered cord syndrome
** PLEASE DESCRIBE THIS IMAGE ** Toxoplasmosis.
** PLEASE DESCRIBE THIS IMAGE ** Trinica Zimmer cervical miniplate with Fidji cages and Novabone.
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Tuberculous granulomatous compression of the
cervical spine
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When Hi-Tech is not needed!