Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
Neurodegenerative diseases include a very wide group of
disorders affecting the central nervous system (CNS).
Many of these disorders arise from the combined effects
of genetic predisposition and environmental factors.
This results in reduced cognition (e.g. Alzheimerís
disease, dementia with Lewy bodies, and vascular
dementia), motor system performance (e.g. amyotrophic
lateral sclerosis), or both (e.g. Parkinsonís disease
and prion diseases). In general, neurodegenerative
diseases show a wide diversity of etiology and a broad
clinical phenotype spectrum, but all have in common the
decrease in neuronal function and neuronal cell death
due to activation of apoptotic pathways, programmed cell
death, or other mechanisms.
The evolution of magnetic resonance (MR) techniques for
imaging the CNS has led to significant advances in the
understanding of brain changes associated with
neurodegenerative disorders. Conventional MR imaging
(MRI) provides detailed anatomic information with
excellent tissue contrast and spatial resolution.
Additional MR sequences can provide information
concerning tissue metabolism, water diffusion, and
perfusion. All together, these MR modalities have been
demonstrated to be relevant in the clinical evaluation
of neurodegenerative disorders for early diagnosis,
differential diagnosis, and monitoring of disease
activity. MR spectroscopy (MRS), in particular, has
provided insights into some of the metabolic
abnormalities associated with neurodegeneration, thereby
helping to elucidate the underlying pathophysiology of
these disorders, although it has yet to have significant
impact in routine clinical usage. The goal here is to
describe the common findings of MR spectroscopy (MRS) in
this field and its limitations. We will focus on proton
MRS (1H-MRS), as the majority of MRS studies in
neurodegenerative disorders utilize this technique and
it can readily be performed as part of a routine MR
study. It should be stressed, however, that other nuclei
(such as 31P or 13C) have been used in research studies
of various neurodegenerative disorders.
Dementia is a clinical diagnosis defined as a decline in
memory and other cognitive functions that affect the
daily life in an alert patient. Major causes of dementia
include Alzheimerís disease (AD) and vascular dementia
(VD) and, less commonly, frontotemporal dementia and
dementia with Lewy bodies. Consensus clinical criteria
have been applied for diagnosis of different dementias,
but the sensitivity and specificity of these criteria
are variable. The diagnosis of dementing disorders by
means of the current clinical criteria remains difficult
and, occasionally, due to the mixed pathology existing
in the brain of demented patients, the underlying cause
of dementia cannot be definitely determined even after
the histopathologic examination of the brain.
The difficulty in making diagnoses exclusively based on
the current clinical criteria has generated the
incentive for identifying specific neuroimaging markers
for various dementing pathologies. Thus, in vivo changes
of demented brains have been studied with different MR
modalities with increasing frequency.
In this context, 1H-MRS has been shown to be useful in
the differential diagnosis of dementing illnesses, as
well as in monitoring early disease progression and
effectiveness of therapies.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .