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IN THE MEMORY OF MY GREAT TEACHER

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Carl Ziess Pentero C

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 27 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.
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 Verio 3 tesla fMRI with fibertraking (DTI) for intraoperative monitoring are in practice.
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.

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

ISIS MER for DBS and Lesioning

Medtronic Prestige LP Cervical disc system

OPERATIVE VIDEO GALLERY
  PREVIOUS VIDEO GALLERY 

  VIDEO GALLERY 2000
 
VIDEO GALLERY 2001
 
VIDEO GALLERY 2002
 
VIDEO GALLERY 2003
 
VIDEO GALLERY 2004
 
VIDEO GALLERY 2005
 
VIDEO GALLERY 2006
 
VIDEO GALLERY 2007
 
VIDEO GALLERY 2008
 
VIDEO GALLERY 2009 
 
VIDEO GALLERY 2010
  JANUARY-2010  
 
FEBRUARY-2010 
 
MARCH-2010 
  APRIL-2010

Siemens Verio 3 tesla MRI

BrainLab

** 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 
** PLEASE DESCRIBE THIS IMAGE ** BloodSTOP ix Provoking bleeding in meningioma surgery.
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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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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 ** 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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Medulloblastoma
** PLEASE DESCRIBE THIS IMAGE ** 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
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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 in Adults 
** PLEASE DESCRIBE THIS IMAGE ** Scoliosis in Children
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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 ** The first mortality in pituitary adenoma surgery in my 30 years experience with material over 600 subfrontal operations.
** 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!