Browsing by Author "Azab, Mohammed A."

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Perfusion-Mri for Differentiating Cerebral Metastatic Lesions and Gliomas: an Evidence-Based Review
(Elsevier Sci Ltd, 2025) Azab, Mohammed A.; El-Gohary, Nour; Atallah, Oday; Shama, Mohsen; Ibrahim, Ismail A.
Background: Lesions affecting the brain are variable and have multiple pathologies. Brain metastasis is a common entity of lesions that can be misleading in diagnosis. Brain metastasis affects the patient's life and survival in about 40% of cases; all patients with metastatic brain lesions are indicated for surgery, so proper diagnosis is crucial for each patient. Non-invasive diagnosis is a promising way to confirm the diagnosis of cerebral metastatic lesions for patients who are not indicated for surgery for medical reasons. To our knowledge, this is the first evidence-based review article regarding utilizing perfusion-MRI for approaching cerebral metastatic lesions. Methods: A comprehensive database search on PubMed/Medline, Scopus and Google Scholar was done by the relevant keywords. Eligibility of articles was done by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cochrane risk of bias assessment tool was used to determine the risk of bias among the included studies. Results: From 2989 articles, only 31 studies were eligible for the qualitative synthesis. A comprehensive summary of the included study was made according to population, intervention, comparator and outcomes (PICO) method. Conclusions: Diagnosing cerebral metastases, categorizing subtypes, and monitoring their response to treatment is a challenging endeavor for neurosurgeons, neuroradiologists, and oncologists. Technological advances in MRI software as perfusion-based MRIs are designated to facilitate diagnosis and follow-up for patients with cerebral metastases.
Technical Approaches for Preservation of the Temporalis Muscle in Neurosurgery: A Systematic Review
(Lippincott Williams & Wilkins, 2025) Azab, Mohammed A.; Sarhan, Khalid; Atallah, Oday; Hernandez-Hernandez, Alan; Ibrahim, Ismail A.; Shama, Mohsen Nabih; Kammoun, Brahim
Background:The temporalis muscle is commonly dissected and mobilized during craniotomy. Cosmetic and functional complications may arise from the improper handling of this muscle. Surgery for recurrent pathologies may be challenging due to adhesions and muscle damage.Material and methods:A systematic review following PRISMA guidelines was conducted to consolidate literature on the potential techniques used for preserving the temporalis muscle during neurosurgical interventions. PubMed, Scopus, and Web of Science were systematically searched using predefined criteria from inception to 2025. A qualitative synthesis was done summarizing the primary cranial pathology, type of surgical approach, the technical clue for temporalis muscle preservation, follow up and complications.Results:We included 27 eligible articles with a total number of 811 patients. About 508 (62.6%) of patients underwent pterional approach, while 150 (18.4%) patients had decompressive craniotomies. Aneurysm clipping was the surgical indication in 172 (21.2%) patients, while decompressive surgery was done for traumatic brain injuries in about 48 (5.9%) patients. Osteoplastic temporalis muscle flap was used in 178 (21.9%) patients, while some authors sutured the temporalis muscle to the cranioplasty plate in 79 (9.7%) patients. Fixation of the temporalis muscle to the bone using sutures through small holes was done in 100 (12.33%) patients. No chewing problems were recorded among all the patients analyzed. Temporalis muscle atrophy was observed in only 13 (1.6%) patients.Conclusion:Proper manipulation of the temporalis muscle during surgery is crucial for the vitality of its fibers and to prevent postoperative functional or cosmetic drawbacks.