About us

The stroke and endovascular intervention unit is a quite important division in the neurology department. It admits tens of stroke patients daily from the emergency department. These patients receive different treatment lines according to their conditions, including thrombolytic therapy, mechanical thrombectomy, intermediate and intensive care admission if needed.

During their stay, stroke patients undergo stroke work-up, care of critically-ill patients and various methods of rehabilitation in collaboration with other departments especially Rheumatology and Rehabilitation Department.

Endovascular intervention is a growing field which we try to cope with by all the possible means. In collaboration with Neurosurgery and Radiology departments, the unit minimally invasive procedures using fluoroscopic guidance to help treat many vascular neurological problems. This is done by a highly trained and specialized team using state-of -the-art techniques and equipment.

Additionally, the stroke outpatient clinic is open to patients for follow-up, drug prescription and dealing with stroke complications, under the direct supervision of stroke staff.
 

Members and contacts:

1. Prof Dr Mohamed Abdelsalam Mohamed Ali
2. Prof Dr Ashraf Abdelmonem Elmitwalli
3. Prof Dr Tamer Mohamed Ibrahim Belal
4. Assistant Prof Dr Yasser Ibrahim Wasel
5. Prof Dr Wessam Fathy Mostafa
6. Prof Dr Hossam Egila
7. Dr Monzer Abdelrahman Ibrahim
8. Dr Ahmed Effat Abbas
9. Dr Nada Abdelhameed Elsayed
10. Dr Ahmed Hosny Elawady
11. Dr Eman Abdelhaleem Eltantawy
12. Dr Ali Elsayed Gaber
13. Dr Mohamed Ali Abdelaziz

Research activities:

• El-Mitwalli A, Azzam H, Elmenshawy I, Abu-Hegazy M, Saad M. Coagulation Factor VII R353Q Polymorphism in Patients with Cerebral Venous Thrombosis. Egypt J. Neurol. Psychiat. Neurosurg. April 2014 Vol. 51 2 : 181 – 186.
• Zaher AA, Amer T, Abd El-Gaber N, Hany A. Eldawoody HF, El-Mitwalli A, Gabr, Abd Al-Rahman AM. The Role of Multidetector CT Angiography In Diagnosis and Treatment Planning of Aneurysmal Subarachnoid Hemorrhage. Egypt J. Neurol. Psychiat. Neurosurg. April 2014 Vol. 51 2 : 235 – 241.
• El-Mitwalli A, Azzam H, Abu-Hegazy M, Gomaa M, Wasel Y. Clinical and biochemical aspirin resistance in patients with recurrent cerebral ischemia. Clin Neurol Neurosurg. 2013 Jul;115(7):944-7.
• El-Mitwalli A, Zaher AA, El Menshawi E. Circadian rhythm of stroke onset during the month of Ramadan. Acta Neurol Scand. 2010 Aug 1;122(2):97-101.
• Ashraf El-Mitwalli,Ashraf Ahmed Zaher,Mohamed Abd El-Salam Mohamed,Ibrahim Elmenshawy The Effect of Ramadan Fasting on Cerebral Stroke: A Prospective Hospital-Based Study Egypt J. Neurol. Psychiat. Neurosurg. 2009; 46 (1): 51 – 56.
• Ashraf El-Mitwalli,Abo Zaid Abd Allah,Sherif Sakr,Ahmed Azab,Abdel Razik Maaty Migraine and Patent Foramen Ovale: Transesophageal Echocardiography Study. Should We Exclude Migraine without Aura? Egypt J. Neurol. Psychiat. Neurosurg. 2008; 45 (1): 75 – 82
• Ashraf El-Mitwalli,Mohamed El-Sayed Abd El Hamid,Wael Rifaie,Mohamed Mosbah Predictive and Clinical Value of Cerebral Microemboli Detection in Cardiac Patients  Egypt J. Neurol. Psychiat. Neurosurg. 2008; 45 (1): 107 – 115
• Daoud EM, El-Shahat N, Soliman AW, Helaly MA, El-Mitwalli A, Abdel-Aal E: Effect of Acute Cerebrovascular Stroke on QT dispersion. Benha MJ. 2005; Sept. 22 (3): 681- 696.
• Uchino K, Alexandrov AV, Garami Z, El-Mitwalli A, Morgenstern LB, Grotta JC Safety and feasibility of a lower dose intravenous TPA therapy for ischemic stroke beyond the first three hours. Cerebrovasc Dis. 2005; 19(4): 260-6
• Felberg RA, Okon NJ, El-Mitwalli A, Burgin WS, Grotta JC, Alexandrov AV: Early dramatic recovery during intravenous tissue plasminogen activator infusion: clinical pattern and outcome in acute middle cerebral artery stroke. Stroke. 2002 May; 33(5): 1301-7.
• Wojner AW, El-Mitwalli A, Alexandrov AV. Effect of head positioning on intracranial blood flow velocities in acute ischemic stroke: a pilot study. Crit Care Nurs Q. 2002 Feb; 24(4):57-66.
• El-Mitwalli A, Saad M, Christou I, Malkoff M, Alexandrov AV. Clinical and sonographic patterns of tandem internal carotid artery/middle cerebral artery occlusion in tissue plasminogen activator-treated patients. Stroke. 2002 Jan;33(1):99-102.
• Grotta JC, Burgin WS, El-Mitwalli A, Long M, Campbell M, Morgenstern LB, Malkoff M, Alexandrov AV. Intravenous tissue-type plasminogen activator therapy for ischemic stroke: Houston experience 1996 to 2000. Arch Neurol. 2001 Dec;58(12):2009-13.
• Alexandrov AV, Burgin WS, Demchuk AM, El-Mitwalli A, Grotta JC. Speed of intracranial clot lysis with intravenous tissue plasminogen activator therapy: sonographic classification and short-term improvement.Circulation. 2001 Jun 19;103(24):2897-902.
• Migraine and tension headache comorbidity with hypothyroidism in Egypt. AA Abou Elmaaty, ME Flifel, T Belal, CA Zarad. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 56 (1), 1-7.
• Role of early CT in predicting recovery of ischemic stroke. M Abdelsalam, T Belal, M Hazen, M Saad. Egypt J Neurol Psychiatry Neurolsurg 47, 407-12.
• Pentraxin 3 is Increased Early in Blood of Patients with Cerebral Stroke and Predicts its Severity. T Belal, M Mashaly, IE Elmenshawi. Egyptian Journal of Neurology, Psychiatry & Neurosurgery 52 (2)
• Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension. N Elsaid, T Belal, N Batouty, AAKA Razek, A Azab. Journal of Neuroradiology.
• Detection of central veins using susceptibility weighted imaging (SWI) for discrimination between lesions in multiple sclerosis (MS) and cerebral small vessel disease (CSVD). RA Anan, MA El-Adalany, TMI Belal, SAED Elmogy. Egyptian Journal of Radiology and Nuclear Medicine 51 (1), 1-7
• Cerebrovascular reactivity recovery following carotid angioplasty and stenting. SES Hashem, ES Belal, MM Hegazy, AA El-Bassiony, SM Ahmed, II Zaid. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 55 (1), 1-5.
• Developing an Arabic screening test for adult-onset chronic aphasia. T Abou-Elsaad, H Baz, T Belal, S Elsherbeny. Folia Phoniatrica et Logopaedica 70, 74-81.
• Correlation of cortical lesions of multiple sclerosis at double inversion recovery with cognition screening scores. SM Shaaban, AE Elmongui, AAKA Razek, TM Belal. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 57 (1), 1-8
• Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension. AAKA Razek, N Elsaid, T Belal, N Batouty, A Azab. Ultrasonography (Seoul, Korea)
• Predictive value of the transcranial Doppler and mean arterial flow velocity for early detection of cerebral vasospasm in aneurysmal subarachnoid hemorrhage. A Esmael, ME Flifel, F Elmarakby, T Belal. Ultrasound, 1742271X20976965
• Evaluation of cerebrospinal fluid flow dynamic changes in patients with idiopathic intracranial hypertension using phase contrast cine MR imaging. T Belal, AE Al Tantawy, FM Sherif, A Ramadan. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 56 (1), 1-6
• Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers. A Esmael, T Belal, K Eltoukhy. Stroke research and treatment 2020
• Parinaud syndrome caused by corpus pineale tumour in a 14-year-old boy. S Jandorf, T Belal, C Christakopoulos. Ugeskrift for laeger 180 (43)
• Impact of Hyperglycemia on Cerebral Vasospasm and Delayed Cerebral Ischemia in Spontaneous Subarachnoid Hemorrhage. ES Belal, HS Mourad, SM Ahmed, II Zaid. Egyptian Journal of Neurology, Psychiatry & Neurosurgery 51 (1). 2014.
• Treatment of blood blister aneurysms of the internal carotid artery with flow diversion. M Mokin, A Chinea, CT Primiani, Z Ren, P Kan, VM Srinivasan, R Hanel. Journal of neurointerventional surgery 10 (11), 1074-1078 51. 2018
• Radiological predictors of hemorrhagic transformation after acute ischemic stroke: an evidence-based analysis. N Elsaid, W Mustafa, A Saied. The neuroradiology journal 33 (2), 118-133. 2020.
• Software-based simulation for preprocedural assessment of braided stent sizing: a validation study. KC Joshi, I Larrabide, A Saied, N Elsaid, H Fernandez, DK Lopes. Journal of neurosurgery 131 (5), 1423-1429. 9 2018.
• Endovascular recanalization of symptomatic intracranial arterial stenosis despite aggressive medical management. A Aghaebrahim, GJ Agnoletto, P Aguilar-Salinas, MF Granja, A Monteiro, World neurosurgery 123, e693-e699. 2019.
• First human evaluation of endothelial healing after a pipeline flex embolization device with shield technology implanted in posterior circulation using optical coherence tomography. BP Guerrero, CD Pacheco, A Saied, K Joshi, C Rodríguez. Neurointervention 13 (2), 129 8. 2018.
• Flow diversion for treatment of intracranial aneurysms in pediatric patients: multicenter case series. J Cherian, V Srinivasan, MT Froehler, JA Grossberg, CM Cawley. Neurosurgery 87 (1), 53-62 6. 2020.
• 2D parametric parenchymal blood flow as a predictor of the hemorrhagic events after endovascular treatment of acute ischemic stroke: a single-center retrospective study. N Elsaid, A Saied, K Joshi, J Nelson, J Baumgart, D Lopes. Interventional neurology 7 (6), 522-532. 2018.
• The relation between aortic arch branching types and the laterality of cardio-embolic stroke. N Elsaid, G Bigliardi, ML Dell'Acqua, L Vandelli, L Ciolli, L Picchetto. Journal of Stroke and Cerebrovascular Diseases 29 (7), 104917. 2020.
• Factors Affecting the Degree of Angular Remodeling in Stent-Assisted Coiling of Bifurcation Aneurysms. A Saied, N Elsaid, K Joshi, M Gomaa, T Amer, M Saad, D Lopes. Interventional neurology 8 (2-6), 220-233. 2019.
• E-008 Endovascular recanalization of intracranial arterial stenosis in patients with medical failure. P Aguilar-Salinas, R Hanel, E Sauvageau, D Lopes, A Saied, T Jovin. Journal of NeuroInterventional Surgery 9 (Suppl 1), A45-A45 1. 2017.
• Factors affecting the outcome of delayed intravenous thrombolysis (> 4.5 hours). N Elsaid, G Bigliardi, ML Dell’Acqua, L Vandelli, L Ciolli, L Picchetto. Revue neurologique. 2021.
• Acute Necrotizing Encephalopathy in Egyptian Children–Case Series. A Saied, N Elsaid, T Belal, Z Ahmed, F Sherif. Egyptian Journal of Critical Care Medicine 7 (2 and 3), 68-73. 2020.
• FACTORS AFFECTING THE FATE OF RAYMOND-ROY GRADE 2. N Elsaid, A Saied, D Lopes. INTERNATIONAL JOURNAL OF STROKE 15 (1_ SUPPL), 580-581. 2020.
• Acute necrotizing encephalopathy in childhood-Case series. N Elsaid, A Saied, Z Ahmed, F Sherif. EUROPEAN JOURNAL OF NEUROLOGY 27, 448-448. 2020.
• Long term effects of corticosteroids in multiple sclerosis in terms of the “no evidence of disease activity”(NEDA) domains. A Saied, N Elsaid, A Azab. Steroids 149, 108401. 2019.
• The first objective predictor of the hemorrhagic events after endovascular treatment of acute ischemic stroke using 2D parametric parenchymal blood flow (P1. 3-017). N Elsaid, A Saied, K Joshi, J Nelson, J Baumgart, D Lopes. Neurology 92 (15 Supplement). 2019.
• Babinski’s sign from the evolutional point of view “Why would you think that the big toe is related to your brain?”(P4. 9-048). N Elsaid, A Saied. Neurology 92 (15 Supplement). 2019.
• Impact of daughter vessel selection for stent deployment on the recanalization rates of bifurcation aneurysms treated with single stent-assisted coiling (SAC)(P5. 3-030). A Saied, N Elsaid, K Joshi, M Gomaa, T Amer, M Saad, D Lopes. Neurology 92 (15 Supplement). 2019.
• Novel explanation of angular remodeling in stent assisted coiling (SAC) of bifurcation aneurysms: Is it the stent or the coils?(P5. 3-028). A Saied, N Elsaid, K Joshi, M Gomaa, T Amer, M Saad, D Lopes. Neurology 92 (15 Supplement). 2019.
• Objective Assessment of Arterial Steal Phenomenon in Direct Carotid Cavernous Fistula Using 2D Parametric Parenchymal Blood Flow Analysis. N Elsaid, A Saied, K Joshi, J Nelson, J Baumgart, D Lopes. Neurointervention 14 (1), 63. 2019.
• Time to raise the concern for central nervous system tuberculosis and human immunodeficiency virus in Egypt? Multiple central nervous system tuberculoma: a case report. N Elsaid, A Saied. The Egyptian Journal of Chest Diseases and Tuberculosis 68 (1), 114. 2019.
• Outcomes of Endovascular Treatment of Intracranial Aneurysms at Bifurcation Sites. A Saied, M Gomaa, T Amer, M Saad, D Lopes. World Journal of Neuroscience 8 (4), 432-443. 2018.
• Egyptian Case of Parry-Romberg Syndrome MAES Nada Elsaid, Ahmed Saied. American Journal of Rare Disorders: Diagnosis & Therapy 1 (1), 1-3. 2018.
• Endovascular Recanalization of Intracranial Arterial Stenosis in Patients With Recurrent or Progressive Symptoms Despite Medical Management. A Aghaebrahim, P Aguilar-Salinas, R Santos, AH Siddiqui, EI Levy, ...STROKE 49.2018.

Patient Services

-Management of stroke and follow-up of stroke patients in the outpatient clinic

-Diagnostic evaluation of cerebral vessels stenosis and different vascular lesions such as aneurysms, cranial or spinal arteriovenous malformations (AVMs) and some tumours.

-Treatment of acute strokes using mechanical thrombectomy.

-Treatment of cerebral vessel stenosis by stenting.

-Obliteration of aneurysms by different methods like coiling, flow diversion or other methods.

-Embolization of AVMS.

-Vascular tumours embolization.

Educational activities:
-Endovascular neurology workshop, as part of the 10^th Mansoura Neurology Conference (2/11/2021).