Introduction. Tangential gunshot wounds (TGSW) to the head is the high-velocity bullet that does not penetrate the cranium but passes through the tissue adjoining the cranial cavity, creating a “gutter” wound and indirectly causing cerebral injury. This article presents a reporting case of TGSW to the head, discusses the mechanism underlying this traumatic injury and the possible complications resulting from it, and reviews of literature. Case description. A thirteen-year-old schoolboy was admitted to the emergency department (ER) of the neurosurgery teaching hospital in Baghdad, Iraq, with a tangential gunshot to the head of an unknown source during civilian protests in Baghdad. In addition to a seizure attack in the ER, his Glasgow coma (GCS) scale was 13 initially. The computed tomography showed multiple bilateral brain contusions, interhemispheric haemorrhage, partially depressed fracture of the frontal bone midline, and a Paramedian to the left with a significantly depressed skull fracture. Then, an urgent decompressive craniectomy was performed. The postoperative course was uneventful, with rapid improvement in GCS of 15 one hour after surgery. On the six-month follow-up, the patient reported no further attacks of seizure. Conclusion. TGSWs are associated with good GCS and favourable prognosis in most cases unless the patient has been deteriorating or has an associated ICH. Moreover, in our case, the history taking, mechanism of the injury, rapid evolution, and radiological imaging have an essential effect on the outcome.
This paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv
... Show MoreThe services provided by the municipal institutions of the basic things needed by the man in his daily life and the evolution of cities basically depends on these services and therefore has paid most of the world's attention to this vital facility and give him the biggest concern for the welfare of the citizens, as is the research problem that there is no program scrutiny to evaluate the performance of municipal institutions contribute to measuring the efficiency and effectiveness of the services provided and was based on research on the premise that the preparation of the existence of audit program to evaluate the performance of municipal institutions contribute to measuring the efficiency and effectiveness of services provided has reac
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... Show MoreDisabled people are among the most important groups that need attention, care, and financial and moral care. They cannot fulfill the requirement of life normally without care from a person to meet their special needs. The disability is either mental or physical. The Iraqi government has paid attention to this category by adopting a law for this category, represented by Law No. (38) for the year (2013), which keeps their rights and duties in Iraqi society by establishing institution of persons with disabilities and special needs of the Ministry of Labor and Social Affairs to create a modern society politically, socially, culturally or economically. In view of the importance of this group in society, the media reinforces the communit
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