Prof. Munir Elias

Intraoperative MRI and  Neurophysiologic Suite with Skyra 3 Tesla and All Neurological Siemens Applications. Intraoperative Neurophysiological monitoring using Inomed ISIS 32 channel  and MER with Stereotactic facilities adopted to the MRI,  are also in the run.

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

Dr. Munir Elias MD, Ph.D. Site Author.   

Ceiling suspended full option Carl Ziess Pentero C microscope

SKULL BASE SURGERY

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 37 years period. Here the neurosurgeon can find the standards and new modifications in the treatment strategies in all pathologies involving the skull base with certain approaches and some combination to make the resection of the tumor and correction of the pathology in more secure environment.

The site is part of more widespread field of neurosurgery, including 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.
Using MATLAB and signal processing and Inomed MER and RM stereotactic device with micro-macro electrode recordings, we could translate up to now more than 20 areas of the deep nuclei and surrounding areas of the brain. This is only the start of the project, which with time must cover more than billion of sites in the brain and later the spinal cord, creating the GPS inside the brain and neural structures. This and and the chemical map of neurotransmitters could jump the humanity to new level of understanding the normal and pathologic conditions from different conventional aspects and can lead even to catch the activity of the functioning brain. It is simple as creating a new language and to put the letters, and then the poems and literature according to this new language.  
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 Riechert-Mundinger System, with three point fixation is the most accurate system in the market. The microdrive and its sensor gives feed back about the localization.

 

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

MER

Neurostimulation with ISIS Inomed system.

 

 

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

Prestige LP Artificial cervical disc.

Prestige LP Cervical Disc system Medtronic.

** PLEASE DESCRIBE THIS IMAGE ** Search skullbase.surgery mailto: drmunire@gmail.com

OPERATIVE VIDEO GALLERY
TO SEE YOUR OPERATION
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Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns-online.com
cns.surgery
cns.today
neurosurgery.ag
neurosurgery.bz
neurosurgery.co
neurosurgery.cz
neurosurgery.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips 
neurosurgery.tw
neurosurgeryspine.org
Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
ependymomas.com
glioma.co
gliomas.info 
meningiomas.info
meningiomas.org
neurooncology.me
neurooncology.tv
neurooncology.ws
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com
pituitaryadenoma.net
schwannomas.com

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

Neuroanesthesia Sites
neuroanesthesia.info

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurohistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com
neurophysiology.ws

Neuroradiological Sites
neuroradiology.ws

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com
Personal Sites
cns.clinic
cnsclinic.org
Spine Surgery Sites
spine.surgery
spinesurgeries.org
spondylolisthesis.info
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile RF lesion generator and stimulator for countless applications and many uses.


MultiGen RF lesion generator

About Bipolar Pulsed Mode RadioFrequency  Applications. Please Click here!


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Amyotrophic lateral sclerosis.
** PLEASE DESCRIBE THIS IMAGE ** Anterior & lateral spinal cysts
** PLEASE DESCRIBE THIS IMAGE ** Arnold-Chiari malformation
** PLEASE DESCRIBE THIS IMAGE ** Autoreferat
** PLEASE DESCRIBE THIS IMAGE ** Avoidance of cosmetic deformity in petroclival approaches
** PLEASE DESCRIBE THIS IMAGE ** Bad surgeon-Bad result with unimaginable complications.
** PLEASE DESCRIBE THIS IMAGE ** Basics in metastatic brain tumors 
** PLEASE DESCRIBE THIS IMAGE ** Brain Death
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Brown-Sequard syndrome due to PCD C5-6
** PLEASE DESCRIBE THIS IMAGE ** Cervical discectomy-new concepts
** PLEASE DESCRIBE THIS IMAGE ** Cervical Partial Coporectomy
** PLEASE DESCRIBE THIS IMAGE ** Cervical Spondylosis
** PLEASE DESCRIBE THIS IMAGE ** Congenital torticollis
** PLEASE DESCRIBE THIS IMAGE ** Discectomy prolapsed lumbar disc
** PLEASE DESCRIBE THIS IMAGE ** Drilling help minimize surgical trauma during flavotomy
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First authority to remember.
** PLEASE DESCRIBE THIS IMAGE ** Funny medicine.
** PLEASE DESCRIBE THIS IMAGE **
ENT Induced complications
** PLEASE DESCRIBE THIS IMAGE ** 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
** PLEASE DESCRIBE THIS IMAGE ** 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
** PLEASE DESCRIBE THIS IMAGE ** Isthmic spondylolisthesis
** PLEASE DESCRIBE THIS IMAGE ** 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
** PLEASE DESCRIBE THIS IMAGE ** Lost battle.
** PLEASE DESCRIBE THIS IMAGE ** Medulloblastoma
** PLEASE DESCRIBE THIS IMAGE ** Metastatic brain tumors
** PLEASE DESCRIBE THIS IMAGE ** Modified osteoplastic midline suboccipital approach

** PLEASE DESCRIBE THIS IMAGE ** MultiHans - Bracco induced anaphylactic shock
** PLEASE DESCRIBE THIS IMAGE ** Mycotic cerebral aneurysms
** 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.
** PLEASE DESCRIBE THIS IMAGE ** Old established standards of carpal tunnel release.
** PLEASE DESCRIBE THIS IMAGE ** Optic chiasm glioma
** PLEASE DESCRIBE THIS IMAGE ** Ossification of Posterior Longitudinal Ligament.
** PLEASE DESCRIBE THIS IMAGE ** Pain
** PLEASE DESCRIBE THIS IMAGE **
Paragangliomas
** PLEASE DESCRIBE THIS IMAGE ** Paraplegia
** PLEASE DESCRIBE THIS IMAGE ** Paraplegia discussion 
** PLEASE DESCRIBE THIS IMAGE ** PEEK Satellite Nucleus replacement sphere
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Prestige LP cervical disc system
** PLEASE DESCRIBE THIS IMAGE ** Prolapsed dorsal disc
** PLEASE DESCRIBE THIS IMAGE ** Recurrent prolapsed lumbar disc
** PLEASE DESCRIBE THIS IMAGE ** Sacrococcygeal chordoma.
** PLEASE DESCRIBE THIS IMAGE ** Scoliosis
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Single metastatic brain tumors
** PLEASE DESCRIBE THIS IMAGE ** Spontaneous intracranial hemorrhage.
** PLEASE DESCRIBE THIS IMAGE ** Stem cell therapy results.
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Syringomeylia
** PLEASE DESCRIBE THIS IMAGE ** 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
** PLEASE DESCRIBE THIS IMAGE ** What is Compound Nerve Action Potential-CNAP?
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When Hi-Tech is not needed!