Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a left pure posteriorly directed PCoA aneurysm. In the surgery, through the left pterional approach, all intraoperative steps were carried out. Additional steps were performed as well. Three additional intraoperative steps were contemplated because a pure posteriorly directed PCoA aneurysm is not well appreciated and is often hidden behind the supra cliniold internal carotid artery (ICA). First, the extension of Sylvian fissure dissection to include the distal part and the proximal. Second, temporal pole mobilization is performed by cutting small anterior temporal veins. Third, a brain retractor is placed on the temporal lobe to gently tract the superficial part of the lobe. All these steps widened the surgical corridor to ensure the aneurysm's safe clipping. Conclusion: Surgical clipping is influenced by the aneurysmal dome projection. In a ruptured pure posteriorly directed PCoA aneurysm, further intraoperative steps may facilitate complete access and safe clipping of the aneurysm.
The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education.
... Show MoreThat the possibility of imposing a tax on electronic commerce is increasing interest in it by governments in developed and developing countries alike, and there is interest in a logical by governments and bodies of taxation, in particular in developing countries erosion potential tax in the tax base resulting from the adoption of e-commerce if not mutation rules and tax legislation, local and international to take into account this important economic developments and how to keep up, said the combination of the taxation system is the only way to increase revenue needed to finance government spending on goods and services needed by society.
The most important conclusions reached by the rese
... Show MoreThe purpose of the research is to identify the social capital of the Municipality of Samawah Municipality by defining the level of its three dimensions (the structural dimension, the relational dimension and the cognitive dimension) and identifying the appropriate means that contribute to increasing the structural empowerment of the workers in the Municipality of Samawah. Between the social capital and the structural empowerment of the workers. From the perspective of social capital, the researchers examined the correlation and the effect of dimensions (structural, relational, cognitive) on the structural empowerment of the workers and with data collected from a sample of (168) Samawah, which is part of the Ministry of Constructi
... Show MoreResearch seeks to test the impact of the dimensions of mindfulness on organizational Innovation, proposed in the light of the review literature on two variables of the research, which referred in General to the dynamic relationship between them, as result of weakness of mindfulness as one important factor driving the diversity of innovation and time, ways to sustain and preserve and then support innovations made by creators, weakness in the overall level of organizational Innovation, this represents the problem research, data collection over designing identification, distributed to sample Formed from (30) head Department at a number of colleges of the University of Baghdad, results confirms the validity of resea
... Show MoreThe aim of this research is to find the impact of the efficiency of Management information systems (MIS) on the effectiveness of governmental organizations performance.
To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research attemped to answer the following question: To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research tried to answer the following question: What is the actual utilization of modern admi
... Show MoreThe study aims to highlighting the Creative Accounting practices, identifying their impact on non reliability of financial statement of Insurance companies and Iraqi Public Reinsurance Company. Certain executive managements resort to creative accounting to falsely portray a better image to financial statement users by means of a set of techniques and mechanisms. Thus, impacting the company activities, The study was carried out in state insurance companies and Iraqi Public Reinsurance Company. Miller model is adopted to measure earning management practices. It is one of the tools to detect creative accounting practices and to measure reliability of accounting information of financial statements by applying “White” scale on
... Show MoreThe current study aims at the extent of determining the interest of the Ministry of Higher Education and Scientific Research and its various departments in the process of strategic foresight, and whether this interest is reflected in its strategic decisions if the study relies on an exploratory and analytical approach and has targeted managers in the higher management within this ministry, and the questionnaire has also been used as a basic tool for collecting For data, the study population was (94), (89) questionnaires were distributed, (86) questionnaires were retrieved, and usable questionnaires amounted to (83). The sub-variable had the highest impact on strategic decision-making (intuition), as this research demonstrated the
... Show MoreThe research aims to know the impact of the innovative matrix strategy and the problem tree strategy in teaching mathematics to intermediate grade female students on mathematical proficiency. To achieve the research objectives, an experimental approach and a quasi-experimental design were used for two equivalent experimental groups. The first is studied according to the innovative matrix strategy, the second group is studied according to the problem tree strategy. The research sample consisted of (32) female students of the first intermediate grade, who were intentionally chosen after ensuring their equivalence, taking into several factors, most notably (chronological age, previous achievement, and intelligence test). The research tools con
... Show MoreThe research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right
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