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.
As long as Islamic banks cannot operate in an environment that deals with traditional banking instruments based on the interest rate (bank interest) that is prohibited by Article No. (6) of the Islamic Banking Law No. (43) of 2015 which stipulates that (do not deal in any activity that carries Interest (neither taking nor giving)). Therefore it seeks to provide an alternative strategic solution within the framework of the provisions and rules of Islamic Sharia, on the basis of participating in profit and loss to avoid the method of interest taking and giving, to find investment methods to provide new financial products, such as Islamic certificates of deposit and investment funds according to the method Murabaha, speculation (Mudar
... Show MoreThe adsorption of zirconium, on manganese dioxide from nitric
acid solutions has been studied as a function of shaking time, concentration of electrolytes, concentration of adsorbate and temperature effects (25- 90°C).
Four hours of shaking was appropriate to ensure that the
adsorption plateau was reached and the adsorption of zirconium decrease with an increase in nitric acid concentration. The limiting adsorption capacities at 3 molar nitric acid was 0.2 Zr per mole of Mn02. Working at elevated temperature was in favour
... Show MoreThe aim of the current research is to identify the impact of the SWOT strategy on developing systemic intelligence among students of the Ibn Rushd College of Education for Human Sciences University of Baghdad / College of Education Ibn Rushd for Human Sciences. The current research community consists of (8590) male and female students, divided into (7) departments. The current research relied on one of the partial control designs, which is the design of non-random groups: experimental group and a control group with a pre and post-test. As for the research tool, It was represented by Tourmanin’s Systemic Intelligence Scale (2012) of (50) items that measure the eight components of systemic intelligence. The results of the Mann Whitney te
... Show MoreIs the efficiency of physical and your endurance is of great importance for some activities and field, as it whenever the situation has improved student career was able to perform physical exertion more with energy saving efforts, so the identification of physical aptitude and endurance private students, was based on that there are positively correlated the carrying of training and pregnancy fact on the shoulders of the student. In other words, physical aptitude and endurance in your control level that can be shown by the student during the performance of training and competitions. Therefore, lies the importance of research to test physical aptitude and endurance your help to reveal the career of the body in the light of their relationship
... Show MorePurpose – measure the relationship between operation management strategies as an independent variable on the customer's delight as an approved variable.
Design/methodology/approach – The research sample vocabulary included sales representatives and customers of the researched markets at a rate of (100%). The recovery rate is (95) Customers and (95) delegates for the products for the factory in neighbourhood (Banooks and Karrada ) regions were randomly chosen from an open community in these two residential areas. Statistical methods were used (arithmetic media, standard deviations, t-test, correlation coefficient (Horst), simple regression analysis).
Findings – The people in charge of the factory management nee
... Show MoreThe research aims to a statement of specificity of the Controller of (academic achievement, specialty, job title, length of service, Gender) and its impact on performance, Through a proposed appraisal form includes three main axes and each axis including several specialized elements in the supervisory work in form (check list). as is the importance of research to enable officials of oversight bodies financial identify and diagnose performance Controller through what has this observer of the process of scientific properties when performing supervisory work. Be summarized problem of the research that the lack of regulatory institution with the Controller interesting in terms of the necessary characteristics and requirements and inv
... Show MoreThe topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore
... Show MoreZinc oxide (ZnO) nanostructures were synthesized through the hydrothermal method at various conditions growth times (6,7 and 8 hrs.) and a growth temperature (70, 90, and 100 ºC). The prepared ZnO nanostructure samples were described using scanning electron microscopy (SEM) and X-ray diffractometer to distinguish their surface morphologies and crystal structures. The ZnO samples were confirmed to have the same crystal type, with different densities and dimensions (diameter and length). The obtained ZnO nanostructures were used to manufacture gas sensors for NO2 gas detection. Sensing characteristics for the fabricated sensor to NO2 gas were examined at different operating temperatures (180, 200, 220, and 240) ºC with a low gas concentrati
... Show MoreIn the present time, radioactive contamination is considered one of the most dangerous types of environmental pollution. It usually takes place because of a leakage of radioactive materials to one of the environment natural components, such as, water, air, and soil. Iraq is considered one of the most contaminated environments in the world; this is closely associated with the wars Iraq had suffered from; especially, in 1991 and 2003. Considering the importance of the radioactive contamination and its different health impacts on the population, the current paper is interested in studying this type of environmental contamination and its impact on the birth defects depending on the data available in the annual reports issued by the Iraqi min
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