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.
Background: Non-nutritive sucking habit (NNSH) is the main environmental causative factor that disturbs normal orofacial development. In spite of the harmful effect of pacifier as a NNSH, mothers aware from the other types of NNSH like thumb sucking far more than pacifier use. Open bite is one of the most challenging malocclusions in orthodontics due to the high prevalence of relapse after treatment, so preventing the causative factor of its occurrence is essential at early age of child life. This study aims to assess the impact of two non-nutritive patterns on the development of anterior open bite in primary dentition and to compare which of these habits mostly affect open bite development. Materials and Methods: The sample consisted of
... Show MoreThe research aimed to find the effectiveness of teaching impact of the reflex learning strategy on the fifth class female student achievement of the geography content material). The researcher adopted the null hypotheses (there are no statistically significant differences at (0,05) level between the women score mean of the experimental group student who has been taught by the cement material assigned by the reflex learning strategy, and that of the control group who have been taught by the traditional method on the achievement test. The researcher adopted the post-test experimental design to measure students’ achievement. The population of the present study has been limited to the fifth literary class female stud
... Show MoreThe river water salinity is a major concern in many countries, and salinity can be expressed as total dissolved solids. So, the water salinity impact of the river is one of the major factors effects of water quality. Tigris river water salinity increase with streamline and time due to the decrease in the river flow and dam construction from neighboring countries. The major objective of this research to developed salinity model to study the change of salinity and its impact on the Al-Karkh, Sharq Dijla, Al-Karama, Al-Wathba, Al-Dora, and Al-Wihda water treatment plant along Tigris River in Baghdad city using artificial neural network model (ANN). The parameter used in a model built is (Turbidity, Ec, T.s, S.s, and TDS in)
... Show MoreThe aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks
... Show More: The Aluminium (Al) material emerged as a plasmonic material in the wavelength ranges from the ultraviolet to the visible bands in different on-chip plasmonic applications. In this paper, we demonstrate the effect of using Al on the electromagnetic (EM) field distribution of a compact hybrid plasmonic waveguide (HPW) acting as a polarization rotator. We compare the performance of Al with other familiar metals that are widely used as plasmonic materials, which are Silver (Ag) and Gold (Au). Furthermore, we study the effect of reducing the geometrical dimensions of the used materials on the EM field distributions inside the HPW and, consequently, on the efficiency of the polarization rotation. We perform the study based o
... Show MoreThe subject of the evolution of fire insurance of the hottest topics accidents, because it falls within the commercial insurance, as its importance is reflected for being a security source and contentment of the insured person and so it is worth pointing out the importance of fire insurance in enterprises and organizations of all kinds, because of the guarantee of its assets from meridian as well as protection from the effects of the fire therefore ensure continuity in the performance of their activities
The Audit evedances represent the reconciliation tools between the Financial data shown on financial statements, and the level of satisfaction level of the Auditor about these statements. According that, the Auditor try to achieve the highest quantity of These evidances, and the most satisfactive of it…, but that will be so hard sometimes, when the internal controlling system is not good, and when the Auditor had some satisfied evidences, but not sharp… So, this research comes to inspect the relation between the quantity, and the level of satisfaction, and argument to prove that evidences gives. This research assumes that getting enough evidences leads to reduce faults, improves the auditing operation, and avoids risks. The research
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