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AZHAR UNIVERSITY-AL

FACULTY OF MEDICINE

NEUROSURGERY DEPARTMENT

SPECIFICATIONS PROGRAM DM

BASIC INFORMATION:-A

3- Department:Neurosurgery 2- Title of the program: Neurosurgery MD program

1- Nature of the program: Single

SPECIALIZED INFORMATION: -B

1/1. -To enable candidates to keep with Satisfactory

standards of Neurosurgery patients care by teaching high

level of clinical skills, bedside care skills, in addition to

update medical knowledge as well as clinical experience

and competence in the area of Neurosurgery

1/2. - To be able to participate in research work and to

give the candidate a chance to join an academic job and

to teach young neurosurgeons.

1/3.- To be able to independently operate various

neurosurgical operations.

1/4. To enable candidates to describe and follow the

basic ethical and medicolegal principles relevant to

Neurosurgery.

Objectives of General -1

program:the

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2-Intended learning outcomes (ILOs) for the whole program:

By the end of the program, the candidate should be able to:

2/1Knowledge and understanding:

A. Demonstrate in-depth knowledge and understanding of

theories, basics and updated biomedical, clinical

epidemiological and socio – behavioral science relevant to

his specialty as well as the evidence – based application of

this knowledge to patient care.

B. Explain basics, methodology, tools and ethics of scientific

medical, clinical research.

C. Mention ethical, medico logical principles and bylaws

relevant to his practice in the field of Neurosurgery.

D. Mention principles and measurements of quality assurance

and quality improvement in medical education and in

clinical practice of Neurosurgery.

E. Mention health care system, public health and health

policy, issues relevant to Neurosurgery and principles and

methods of system – based improvement of patient care in

common health problems of the field of Neurosurgery.

2/2 Intellectual outcomes:

A. Apply the basic and clinically supportive sciences which

are appropriate to Neurosurgery related conditions.

B. Demonstrate an investigatory and analytic thinking “problem

– solving “approaches to clinical situation related to

Neurosurgery.

C. plan research projects.

D. Write scientific papers.

E. Participate in clinical risk management as a part of clinical

governance.

F. Plan for quality improvement in the field of medical

education and clinical practice in Neurosurgery.

G. Create / innovate plans, systems, and other issues for

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improvement of performance in Neurosurgery.

H. Present and defend his / her data in front of a panel of

experts.

I. Formulate management plans and alternative decisions in

different situations in the field of the Neurosurgery.

2/3 Skills

2/3/1 Professional and practical skills:

A. Provide extensive level of patient care that is compassionate,

appropriate, and effective for the treatment of health problems

and the promotion of health.

p.s. Extensive level means in-depth understanding from basic

science to evidence – based clinical application and possession

of skills to manage independently all problems in field of

practice.

B. Provide extensive level of patient care for patients with all

common diagnoses and for uncomplicated procedures related

to Neurosurgery.

C. Provide extensive level of patient care for non-routine,

complicated patients and under increasingly difficult

circumstances, while demonstrating compassionate,

appropriate and effective care.

D. Perform diagnostic and therapeutic procedures considered

essential in the field of Neurosurgery.

E. Handles unexpected complications, while demonstrating

compassion and sensitivity to patient needs and concerns.

F. Communicate effectively and demonstrate caring and

respectful behaviors when interacting with patients and their

families in Neurosurgery related situations.

G. Gather essential and accurate information about patients of

Neurosurgery related conditions.

H. Make informed decisions about diagnostic and therapeutic

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interventions based on patient information and preferences, up

to-date scientific evidence and clinical judgment for

Neurosurgery related conditions.

I. Develop and carry out patient management plans for

Neurosurgery related conditions.

J. Counsel and educate patients and their families about

Neurosurgery related conditions.

K. Use information technology to support patient care decisions

and patient education in all Neurosurgery related clinical

situations.

L. Perform competently all medical and invasive procedures

considered essential for Neurosurgery related conditions / area

of practices.

M. Provide health care services aimed at preventing

Neurosurgery related health problems.

N. Lead health care professionals, including those from other

disciplines, to provide patient-focused care in Neurosurgery

related conditions.

O. Write competently all forms of patient charts and sheets

including reports evaluating these charts and sheets ( Write

and evaluate a consultation note, Inform patients of a diagnosis

and therapeutic plan, completing and evaluating

comprehensive, timely and legible medical records)

2/3/2 General skills

Including:

•Practice-based Learning and Improvement.

•Interpersonal and Communication Skills.

•Professionalism.

•Systems-based Practice.

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Practice-Based Learning and Improvement

A. Demonstrate continuous evaluation of different types of

care provision to patients in the different area of Neurosurgery

B. Appraise scientific evidence.

C. Continuously improve patient care based on constant

selfevaluation and life-long learning.

D. Participate in clinical audit and research projects.

E. Practice skills of evidence-based Medicine (EBM).

F. Educate and evaluate students, residents and other health

professionals.

G. Design logbooks.

H. Design clinical guidelines and standard protocols of

management.

I. Appraise evidence from scientific studies related to the

patients’ health problems.

J. Apply knowledge of study designs and statistical methods

to the appraisal of clinical studies.

K. Use information technology to manage information, access

on-line medical information; for the important topics.

Interpersonal and Communication Skills

L. Master interpersonal and communication skills that result in

the effective exchange of information and collaboration with

patients, their families, and health professionals, including:-

• Present a case.

• Write a consultation note.

• Inform patients of a diagnosis and therapeutic plan

completing and maintaining comprehensive.

• Timely and legible medical records.

• Teamwork skills.

M. Create and sustain a therapeutic and ethically sound

relationship with patients.

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N. Elicit and provide information using effective nonverbal,

explanatory, questioning, and writing skills.

O. Work effectively with others as a member or leader of a

health care team or other professional group.

Professionalism

P. Demonstrate respect, compassion, and integrity; a

responsiveness to the needs of patients and society.

Q. Demonstrate a commitment to ethical principles including

provision or withholding of clinical care, confidentiality of

patient information, informed consent, and business practices.

R. Demonstrate sensitivity and responsiveness to patients’

culture, age, gender, and disabilities.

Systems-Based Practice

S. Work effectively in health care delivery settings and systems

related to Neurosurgery including good administrative and time

management. T. Practice cost-effective health care and resource allocation

that does not compromise quality of care.

U. Advocate for quality patient care and assist patients in

dealing with system complexities.

V. Design, monitor and evaluate specification of under and

post graduate course and programs.

W. Act as a chair man for scientific meetings including time

management.

3- Program Academic Reference Standards (ARS):

Neurosurgery departmrnt of Al –Azhar university refers to the

general academic standards of the National Authority for

Quality Assurance and Accreditation of Education (NAQAAE).

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4- Program External References (Benchmarks):

Neurosurgery departmrnt of Al –Azhar university refers to

The American Board of neurological Surgery/

Also aware about . www.abns.org/content/default.asphttp/

and in contact with the international rules and new

researches and techniques.

5- Program Structure and contents:

Time duration of the program:-A

Basic topic in neurosurgery and general clinical topic(24

months)

Specific neurosurgical topic (36 months)

Structure of the program: -B

Currently 2 units are involved

The student will need 60 points divided as follow

1- Basic science 6 points

2- Specific neurosurgical 29 points

Topic & practice

3-Thesis 15 points

4- Log book 10 points

N.B. one point equals 15 hours of lectures

One point equals 45 hours of skills .

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6- Contents, thesis and Log book:

Basic science for the Neurological surgeon : 1) Neuroanatomy:

including surgical anatomy of the brain, spine and

peripheral nerves with special emphasis on microsurgical

anatomy and neuroembryology.

2) Neurophysiology:

including physiology of cerebrospinal fluid and intra -

cranial pressure, control of cerebral vasculature including

the blood brain barrier.

3) Neuropathology:

of diseases of C.N.S , peripheral nervous system, skull

and spine.

4) Neuroradiology:

o Basic techniques of radiological studies.

o Normal anatomic structures in plain x ray, CT, MRI

and angiographic films.

o Indication of radiological tools in each pathology.

o Recognition of common pathologies on radiographic

films. o Intraoperative fluoroscopy.

o Transcranial Doppler.

o Radionuclide scanning.

o Interventional endovascular therapies.

o Positron emission tomography.

o MR spectroscopy.

5) Neurology:

1- Basic understanding of electrophysiological studies.

2- Delirium and dementia.

3- Coma.

4- Cerebro-vascular disease.

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5- Cerebral metabolism and pathophysiology of

ischaemic brain damage.

6- Metabolic disorder of the nervous system.

7- Acquired neuropathies.

8- Heriditary disorders.

9- Epilepsy.

Specific neurosurgical topic and practice

• Clinical examination of the Nervous system and approach to

the patient :

1- History and physical examination. 2- Altered states of consciousness.

3- Neuro-ophthalmology. 4- Neuro- otology.

5- Neuro- urology.

6- Brain death & Legal issues.

• General and perioperative Care

1- Initial evaluation and treatment of the comatose

patient.

2- Seizure disorders and their medical management.

3- Evaluation of the patient with dementia and

treatment of normal pressure hydrocephalus.

4- Increased intracranial pressure, Brain herniation.

5- Pseudotumour cerebri.

6- Preoperative evaluation of a neurosurgical patient.

7- Neuroanaesthesia and cerebral protection.

8- Intensive care for neurosurgical patient.

9- Postoperative care and evaluation.

10- Complication avoidance in Neurosurgery.

11- Rehabilitation of the neurologically disabled patient.

12- Restorative Neurology.

13- Nutrition and parenteral therapy.

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• Neurosurgical and related techniques.

1- Principles of neurosurgical operative technique.

2- Instrumentation in neurosurgery including

microneurosurgery.

3- High speed drills and ultrasonic dissection in neurosurgery.

4- Endoscopic neurosurgery.

5- Prophylactic antibiotics.

6- Patient positioning.

7- Intraoperative ultrasound, CT and MR.

8- Intraoperative monitoring.

9- Endovascular therapy of vascular lesion of the C.N.S.

10- Interventional neuroradiology.

11- Stereotactic surgery , principles and techniques.

• Neuro-oncology:

1- General information and basic science of Neuro-oncology:-

a) Oncogens and nervous system tumors.

b) Genetic factors in brain tumors.

c) Neurofibromatosis and other phacomatoses.

d) Virus, radiation and chemical induced brain tumors.

e) Biochemistry of brain tumors.

f) Immunology of brain tumors.

g) Primary brain tumors, aspects of imaging and

functional localization.

h) Tumor markers.

i) Brain edema and tumors –host interaction.

j) Brain tumors during pregnancy.

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2- Gliomas:

- Pathology of gliomas.

- Imaging of supratentorial glioma.

- Clinical features and surgical therapy of supratentorial

gliomas.

- Management of recurrent gliomas.

- Unusual gliomas

3- Metastatic brain tumours.

4- Meningiomas (overview- pathology- imaging-

management)

5- Meningeal haemangiopericytoma & meningeal sarcoma.

6- Epidermoid and dermoid tumour (pathology-imaging and

management)

7- Pineal region tumours (pathology- imaging and

management)

8- Cerebellopontine angle tumors (pathology- imaging and

management)

9- Posterior fossa tumours (pathology – imaging

management).

- Cerebellar astrocytoma.

- Medulloblastomas.

- Brain stem glioma.

- Ependymomas & subependymomas.

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- Haemangioblastomas.

10- Sellar and parasellar tumours ;

- Anatomy and physiology of the pituitary gland.

- Classification and pathology of pituitary tumours

- Imaging of sellar and parasellar lesions.

- Endocrine diagnosis in neurosurgery.

- Functioning and non functioning pituitary tumours.

- Pituitary apoplexy.

- Craniopharyngioma.

- Optic gliomas.

- Suprasellar germinomas.

- Management of sellar tumours.

11- Ventricular tumours (pathology, imaging and

management)

12- Tumours of the orbit (pathology, imaging and

management)

13- Tumours of scalp , skull and skull base:

a) Non invasive tumors of the scalp.

b) Tumours of the skull.

c) Chordoma and chondrosarcoma.

d) Glomus jugular tumours.

e) Neoplasms of the paranasal sinuses.

f) Trigeminal neurinoma.

g) Other cranial nerve schwannomas

h) Surgical approaches to tumours of the skull base.

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14- Miscellaneous neoplasms and nonneoplastic tumours :

a) Primitive neuroectodermal tumours.

b) Central nevous system lymphomas.

c) Intracranial sarcomas.

d) Intrcranial lipomas.

e) Sarcoidosis , tuberculosis and xanthogranuloma.

f) Langerhans cell histocytosis.

15- Spinal tumours:

a) Imaging spinal tumours.

b) Intradural tumours of the spine.

c) Spinal epidural tumours.

d) Primary neoplasm of the spine.

e) Spinal chordomas.

f) Vertebral haemangioma.

g) Masses of the sacrum.

16- Tumour of cranio-cervical junction.

17- Adunctive therapy of central nervous system tumours:

a) Conventional radiotherapy.

b) Radiosurgery for tumours.

c) Interstitial brachytherapy.

d) Chemotherapy of primary brain tumours.

e) Photoradiation therapy for malignant gliomas.

f) Hyperthermia in the treatment of intracranial tumours.

• Vascular diseases of the Nervous system .

1 - General information and basic science:

a) Cerebral blood flow and metabolism.

b) Acute medical management of ischemic disease and

stroke.

c) Anaesthesia for neurovascular procedures and

introaperative cerebral protection.

2- Vascular and blood flow evaluations:

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a) Transcranial Doppler ultrasonography

b) Neurosonology

c) Xenon computed tomography

d) MRA

e) Positron emission tomography cerebrovascular disease

3- Occlusive vascular disease:

a) Carotid occlusive disease (natural history and medical

management.

b) Carotid endarterectomy.

c) Carotid angioplasty and stenting.

d) Recurrent carotid stenosis.

e) Traumatic carotid injury.

f) Nonatherosclerotic carotid lesions.

g) Extracranial vertebral artery disease.

h) Intracranial occlusive disease and Moyamoya.

i) Cerebral venous and sinus thrombosis.

4 - Intracerebral hemorrhage (non arteriovenous malformation

, nonaneurysm)

5- Hemorrhagic vascular disease:

A- Aneurysms:

1- Genetics of intracranial aneurysm.

2- The natural history of unruptured saccular cerebral

aneurysm.

3- Imaging of intracranial aneurysm.

4- Surgical decision making for treatment of cerebral

aneurysm.

5- Perioperative management of subarachnoid hemorrhage.

6- Cerebral vasospasm.

7- Aneurysm clips.

8- Surgical approaches for anterior circulation aneurysms .

9- Surgical treatment of intracavernous and paraclinoid

internal carotid artery aneurysms.

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10- Intracranial internal carotid artery aneurysm.

11- Anterior communicating artery and anterior cerebral

artery aneurysms.

12- Distal anterior cerebral artery aneurysms.

13- Middle cerebral artery aneurysms.

14- Surgical approaches for posterior circulation aneurysms.

15- Vertebral artery , posterior inferior cerebellar artery ,

and vertebrobasilar junction aneurysms.

16- Basilar trunk aneurysms

17- Basilar apex and posterior cerebral artery aneurysms.

18- Endovascular treatment of aneurysms.

19- Giant aneurysms.

20- Infectious intracranial aneurysms.

21- Revascularization techniques for complex aneurysms

and skull base tumours.

22- Traumatic cerebral aneurysms secondary to

penetrating intracranial injuries.

B- True arteriovenous malformation

1- Intracranial arteriovenous malformation.

2- Natural history of intracranial vascular malformation.

3- Classification and decision making in treatment and

perioperative management including surgical and

radiosurgical decision making.

4- Endovascular management of brain arteriovenous

malformation.

5- Embolization of arteriovenous malformation.

6- Surgical management of supratentorial arteriovenous

malformation.

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7- Posterior fossa arteriovenous malformation.

8- Surgical and radiosurgical management of giant

arteriovenous malformation.

9- Treatment of lateral – sigmoid and sagittal sinus dural

arteiovenous malformation.

10- Vein of Galen malformation.

C - Cavernous malformations

D - Carotid cavernous fistulas

E - Spinal arteriovenous mal formations

F - Pregnancy and treatment of vascular disease

Pediatric Neurosurgery

- Overview

1- Neuro surgery of the fetus.

2- Neurological examination in infancy and childhood.

3- Neuro anesthesia in children.

- Developmontal and acquired anomalies:

1- Encephaloceles.

2- Myelomeningocele and myelocystocele.

3- Lipomyelomeningocele.

4- Tethered spinal cord.

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5- Occult spinal dysraphism.

6- Dandy walker syndrome.

7- Arachnoid cysts.

8- Craniopagus twins.

- Craniosynostosis.

- Craniovertebral junction anomalies.

- Chiari malformation, hydromyelia, syringomyelia.

- Hydrocephalus:

1- Physiology of cerebrospinal fluid shunt devices.

2- Hydrocephalus in children.

3- Infantile post-hemorrhagic hydrocephalus.

4- Shunt infection.

5- Neuroendoscopy.

- Vascular disease:

1- Vein of Galen malformation.

2- Arteriovenous malformation and intracranial aneurysms

in children.

- Head and brain trauma:

1- Pediatric head injury.

2- Mild brain injury in children including small fractures and

growing fractures.

3- Subdural hematoma and effusions.

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- Birth trauma:

1- Birth head trauma.

2- Brachial plexus injury.

3- Child abuses.

4- Vertebral column and spinal cord injuries.

- Benign spine lesions.

- Tumors:

1- Optic pathway and hypothalamic gliomas

2- Intracranial Germ cell tumors.

3- Choroid plexus tumors.

4- Intracranial ependymomas.

5- Medulloblastomas.

6- Cerebellar astrocytomas in children.

7- Brain stem gliomas.

8- Craniopharyngiomas.

9- Pediatric cerebral hemispheric tumors.

10- Intraspinal tumor in infants and children.

11- Benign tumors of the skull including fibrous dysplasias.

- Cerebral palsy and other spastic entities.

- Surgical treatment of epilepsy in children.

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Cranial and spinal trauma

Cranial trauma:

1- Cellular basis of injury and recovery from trauma.

2- Pathophysiology of traumatic brain injury.

3- Pathophysiology of closed head injury.

4- Neurological evaluation of a patient with head trauma,

coma scales.

5- Radiological evaluation of head trauma.

6- Resuscitation of the multiply injured patient.

7- Intensive management of traumatic brain injury.

8- Pediatric head injury.

9- Scalp injuries.

10- Cephalic hematoma and subgaleal hematoma.

11- Skull fractures.

12- Growing skull fractures of childhood.

13- Facial fracture.

14- Cerebrospinal fluid fistula and pneumocephalus.

15- Cranial defects and cranioplasty.

16- Traumatic intracranial hematoma.

17- Delayed and recurrent intracranial hematoma and post

traumatic coagulopathies

18- Penetrating wounds of the head.

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19- Vascular lesions resulting from head injury.

20- Diagnosis and management of seventh and eighth cranial

nerve injuries due to temporal bone fractures

21- Sequelae of head injury.

22- Rehabilitation and prognosis after traumatic brain injury.

Spinal trauma

1- Management of acute spinal cord injury.

2- Diagnostic evaluation of spinal trauma.

3- Cervical spine trauma.

4- Hyperextension and hyperflexion injuries of the cervical

spine.

5- Treatment of occipital C1 injury.

6- Treatment of axis fractures.

7- Diagnosis and management of thoracic spine fracture.

8- Diagnosis and management of thoraco-lumbar and lumbar

spine injuries.

9- Injuries to the sacrum and pelvis.

10- Penetrating wounds of the spine.

11- Posttraumatic syringomyelia.

• Infections

1- Antimicrobials for use in neurosurgical patients.

2- Diagnosis and management of brain abscess.

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3- Acute bacterial meningitis.

4- Inflammatory thrombosis of major dural venous sinuses

and cortical veins.

5- Cranial epidural abscess and subdural empyema.

6- Infections of the scalp and osteomyelitis of the skull.

7- Pituitary abscess.

8- Spinal cord abscess.

9- Spinal epidural and subdural abscesses.

10- Pyogenis osteomyelitis of spine. 11- Chronic granulomatous lesions.

12- Neurosurgical aspects of immunodeficiency.

13- Herpes simplex virus infection.

14- Creutzleldt- Jacob disease and related diseases.

15- Fungal infection.

16- Parasitic infestations

• Spine

- Basic science

1) Biologic strategies for central nervous system repair.

2) concepts and mechanisms of biomechanics.

3) Intraoperative electrophysiologic monitoring of spinal

cord and nerve roots.

4) Bone metabolism as it relates to spinal disease and

treatment.

5) Normal and abnormal embryology of the spinal cord and

spine.

- Approach to the patient:

1) Approach to the patient and medical management of

spinal disorders.

2) Evaluation and management of the failed back syndrome.

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3) Metabolic and other non degenerative causes of low back

pain.

• Degenerative diseases:

1) Treatment of disc and ligamentous disease of the cervical

spine.

2) Posterior approach to cervical degenerative disease.

3) Anterior approach to cervical degenerative disease.

4) Anterior approach including cervical corpectomy.

5) Cervical spondylotic myelopathy.

6) Spondyloarthropathies including ankylosing spondylitis.

7) Ossifications of the posterior longitudinal ligament other

enthesopathies.

8) Benign extradural lesions of the dorsal spine.

9) Treatment of disc disease of the lumbar spine.

10) Lumbar spinal stenosis.

11) Spondylolysis and spondylolithesis.

12) Adult thoraco lumbar scolisis.

• Adult congenital abnormalities

Acquired abnormalities of the craniocervical junction.

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Techniques

1- Basic principle of spinal internal fixation.

2- Technical aspects of bone graft harvest and spinal

fusion.

3- Biology of bone grafting and healing in spinal surgery.

* Instrumentation

1) Anterior cervical instrumentation.

2) Posterior cervical stabilization and fusion techniques.

3) Occipitocervical fusion.

4) Anterior thoracic instrumentation.

5) Posterior thoracic instrumentation.

6) Anterior lumbar instrumentation.

7) Posterior lumbar instrumentation.

8) Image-guided spinal navigation.

9) Endoscopic approaches to the spine. 10) Intradiscal and percutaneous treatment of lumbar disc

disease.

Tumors of the spine

a) Tumors of craniovertebral junction.

b) Spinal cord tumors in adults.

c) Tumors of the vertebral axis (benign, primary malignant

and metastatic tumors).

Radiation therapy and radiosusgery

Basic science of radiotherapy:

1- Radiobiology.

2- Principles of radiotherapy.

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Fractionated radiation therapy:

1- Fractionated radiation therapy for malignant brain tumors.

2- Radiotherapy for benign skull base tumors.

3- Fractionated radiation therapy for pituitary tumors.

4- Radiotherapy of tumors of the spine.

5- Radiosusgery of brain tumors.

6- Radiosusgery for arteriovenous malformation.

7- Functional radiosusgery.

8- Interstitial and intracavitary irradiation of brain tumor.

Techniques of radiosurgery:

1- Linac radiosurgery.

2- Gamma knife radiosurgery.

3- Proton radiosurgery.

Disorders of peripheral and cranial nerves and autonomic

nervous system:

1- Physiology of the peripheral nerve

2- Peripheral nerves, approach to the patient.

3- Peripheral neuropathies.

4- Electrodiognostic evaluation of peripheral nerve, E.M.G,

Somatosensory evoked potential, nerve action potential.

5- Magnetic resonance imaging for peripheral nave

disorders.

6- Peripheral nerve injuries; types, causes and grading.

7- Thoracic outlet syndromes.

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8- Entrapment neuropathies.

9- Brachial plexus injuries.

10- Management of peripheral nerve injuries.

o Carpal tunnel syndrome.

o Ulnar nerve entrapment at the elbow.

o Entrapment syndromes of peripheral nave injuries.

o Management of peripheral nerve tumors.

o Diagnostic biopsy of peripheral naves and muscles.

o Management of acute peripheral nerve injuries.

11- Posterior fossa neurovascular compression syndromes

other than neuralgia.

12- Treatment of hemi facial spasm and essential

blepharospasm with botulinum toxin.

13- Vestibular nerve sectioning for Menier's disease.

14- Surgical sympathectomy.

15- Stereotactic radio frequency sympathectomy.

16- Endoscopic thoracic sympathectomy.

Epilepsy

- Overview

1- General and historical consideration of epilepsy surgery.

2- Basic science of post- traumatic Epilepsy

3- Approaches to the diagnosis and classification of

Epilepsy

4- Anti-epileptic medication, principles of clinical use.

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- Preoperative evaluation for Epilepsy

a) Single photon emission computed tomography and

positron emission tomography.

b) Preoperative Evaluation for epilepsy surgery,

computed tomography and magnetic resonance

imaging.

c) The intracarotid amobarbital procedure (Wada test).

d) Factional magnetic resonance imaging in Epilepsy

surgery.

e) Identification of candidate for epilepsy surgery.

Intraoperative mapping and monitoring for cortical resections:

1- Motor, sensory, and language mapping and monitory for

cortical resections.

2- Monitory and mapping of vision in the neurosurgical

patient.

- Specific operative approaches

1- Intracranial monitoring.

2- Epilepsy surgery, outcome and complication.

3- Surgery for extra-temporal lobe epilepsy.

4- Standard temporal lobectomy and transsylvian

amygdalo-hippocampectomy

5- Tailored Resection for Epilepsy.

6- Lobectomy uses and indication.

7- Multiple subpial transaction.

8- Vagus nerve stimulation for intractable epilepsy.

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• Functional neurosurgery.

A- Movement disorders:

- Basic science

1- Rationale for surgical intervention in movement

disorders.

2- Anatomy and synaptic connectivity of the basal ganglia.

3- Neuro pathology of movement disorders.

- Approach to the patient and the diagnosis:

1- Approach to movement disorders.

2- Patient selection in movement disorder.

3- Positron emission tomography in movement disorders.

- Surgery of movement disorders

1- Thalamotomy for tremor.

2- Pallidotomy for Parkinson's disease.

3- Surgery for dystonia.

4- Deep brain stimulation for movement disorders.

5- Cellular transplantation in the central nervous system.

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B- Spasticity:

1- Ablative surgery for spasticity.

2- Management of spasticity by central nervous system

infusion.

3- Selective peripheral denervation for spasmodic torticollis.

4- Treatment of intractable vertigo.

C- Pain

1- Physiologic anatomy of pain.

2- Approach to the patient:

- Approach to the patient with chronic pain.

- Medical management of chronic pain.

- Management of pain by anesthetic techniques.

3- Trigeminal neuralgia:

- Diagnosis and non-operative management.

- Percutaneous techniques.

- Microvascular decompression of the trigeminal nerve.

- Alternative surgical treatment for trigeminal neuralgia.

4- Surgical treatment of pain:

o Neurosurgical management of intractable pain.

o Dorsal rhizotomy and dorsal root ganglionectomy.

o Dorsal root entry zone and brain stem ablative

procedures.

o Cordotomy for pain.

o Brain stem procedures for management of pain.

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o Caudalis nucleus dorsal root entry zone procedure for the

treatment of intractable facial pain.

o Sympathectomy for pain.

o Spinal cord and peripheral nerve stimulation for chronic

intractable pain.

o Deep brain stimulation for chronic pain.

o Intrathecal drug infusion for pain.

Stereotactic surgery:

� Stereotactic surgery principles and techniques.

� Image guided stereotactic surgery.

� Computer assisted stereotactic microsurgery.

� Frameless stereotactic interactive image guided

neurosurgery.

� Radiofrequency lesion-making in the nervous system.

� Neurosurgery for behavioral disorders.

� Neural prosthesis.

� Transplantation of tissue to the brain.

Miscellaneous topics

� Disability evaluation;

� Patient education.

� Clinical research.

� The arts and scinse of clinical research.

� Brain death.

� Transplantation of cadaver tissue and organs.

� Intraoperative microphotography.

� Intraoperative video in neurosurgery.

Thesis: The candidate makes the thesis within 2 years(minimally) and

should be finished before the exam.

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Log book: The Log book is specified for each MD candidate, starts

from the date of registration for the degree and continues for

the whole study and training period, fulfillment of the Log book

criteria is considered a mandatory requirement for the final

exam. It includes:

A-Surgical procedures:

1- Surgical assistance for at least 100 surgical

procedure that include different neurosurgical variants

with at least 50 of major cranial and spine surgeries.

2-Doing at least 50 surgical operations that include

different cranial, spine and peripheral nerves surgery

that results in the end of the program by being able to

do the cranial and spine surgery himself.

3-Doing or assistance in urgent and emergeny

operations for the cranium, spine and peripheral

nerves (at least 50 operations) provided that he does

at leat 25 procedures himself.

B- Clinical rounds for the inpatients:

Once a week with presentation of a case and

discussion with the staff of the department.

C- On-call at least once a week.

D- Management of the clinic cases.

E- Scientific activity:

1-Regular weekly attendance of the scientific day of

the department with active participation and

presentation of a subject according to the schedule.

2- Nreurosuregry lectures attendance in the

department.

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3- Attendance of the scientific meetings of the

department and those done with other departments.

4- Attendance of neurosurgery conferences.

5- Attendance of thesis discussions in

the department.

7- Pre-requests for admission to the program:

According to the rules made by Al-Azhar faculty of medicine:

1-The candidate should pass 3 years of residency of neurosurgery and should

present the documents.

2-Should be practicing in the field of neurosurgery in one of the known centers or

working in our department in fixed position or as a fellow or visitor and should

present the documents.

8- Methods and rules for assessment for attendance of the

program:

What to measure of ILOS Method Knowledge and understanding Written exam Knowledge & understanding

Intellectual skills Oral exam

Professional skills & general skills Clinical exam Professional skills & Intellectual skills OSCE

8- Methods of evaluation of the program:

Sample Method Evaluator attached questionair 1-Graduates Prof Dr Mamdouh Salama

2-External evaluator

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Co-ordinator Head of the department Dr Usama El Shokhaiby Prof. Dr Ibraheem Ewis