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.
Abstract:
This research sheds light on the major sins (fornication and sodomy) as two crimes that are prohibited by the divine laws, including its conclusion by the Islamic Sharia. Major sins so that life and the universe are organized, and the individual lives a life of chastity and purity free of filth and filth. The Islamic message included a set of preventive measures and remedial methods that, if the ummah were to apply them, they would live a decent life full of noble goals.
يعد الاقتصاد الياباني احد اكبر الاقتصادات الرأسمالية المتقدمة ويحتل المرتبة الثالثة بعد الاقتصاد الأمريكي واقتصاد الاتحاد الاوربي من حيث حجم الناتج المحلي الإجمالي والذي يكاد يقترب من (5) تريليون دولار سنويا.
لقد ادت التطورات المتلاحقة التي شهدها الاقتصاد العالمي وخاصة في حقل التمويل الدولي خلال العشرين سنة الاخيرة الى تصاعد وارتفاع في حجم وحركه رؤوس الاموال الدولية على اوسع نطاق بحيث ا
... Show Moreتعد المحاسبة بشكل عام علماً لكنها ليست من العلوم الصرفة وإنما من العلوم الإجتماعية مما يتطلب للتعامل مع المواضيع المحاسبية الأخذ بنظر الاعتبار الأشخاص المعنيين بالموضوع سواء كانوا المعدين للمخرجات المحاسبية أي المحاسبين، أو الاطراف ذوي المصالح المعنيين والمستفيدين من هذه المخرجات أي المستخدمين، ويعد المحاسب جزءاً من العملية الاجرائية نفسها وبهذا يكون دوره مزدوجاً يجمع بين كونه القائم بالبحث والقي
... Show MoreSoft red winter wheat (SRW) is characterized by high yield and relatively low protein content. In Kentucky, there is growing demand from local artisan bread bakers for regionally produced flour, requiring production of grain with increased protein content and/or strength. The objective of this two-year field experiment was to evaluate the effect of nitrogen (N) management on five cultivars of winter wheat on yield and bread baking quality traits of modern and landrace SRW cultivars (Triticum aestivum L.). All five cultivars were evaluated using two N application rates in conventional and organic production systems. All traits measured were significantly affected by the agricultural production system and N rate, although plant height
... Show MoreIn this work, the impact of different geomagnetic storm events on the plasma-sphere layer (ionosphere layer) over the northern and southern hemisphere regions was investigated during solar cycle 23. To grasp the influence of geomagnetic storms on the behavior and variation of the critical frequency parameter of the F2 ionospheric layer (foF2), five geomagnetic storms (classified as great, severe, and strong), with Disturbance storm time (Dst) values <-100 nT were chosen. Four stations located in different mid-latitude regions in northern and southern hemispheres were designated, the northern stations are: Millstone Hill (42.6° N, 288.50° W) and Rome (41.90° N, 12.50° E) and the southern stations are: Port Stanley (-51.60° S,
... Show MoreVitamin D is one of several nutrients essential for calcium metabolism. Body weight status and magnesium may influence vitamin D activity. To determine whether salivary vitamin D, magnesium, and calcium levels are associated with body weight status and dental caries severity in children, this cross‐sectional research was conducted.
The sample consisted of 180 boys aged 6–8 years. According to their body mass index (BMI), children were assigned to three groups of 60 boys (normal weight, overweight, and obese). Moreover,
The present study aimed to investigate the possible production of Thioflavin T and the effect of NaCl concentrations and growth phases on the growth rate, doubling time and proline of C. saipanensis N. Hanagata (Scenedesmaceae, Shaerophleales). The alga was cultured in BG 11 medium and six NaCl concentrations were used in the experiments during different growth phases. The results have unveiled the presence of Triflavin T in the alga. The study results showed a growth rate decrease at all NaCl concentrations except in control treatment, while the doubling time, was recorded highest value (14 days) at the NaCl concentration of 0.08 M. The highest value of Proline (0.509 mg. Lˉ¹) was recorded at the treatment of 0.08 M of NaCl and recorded
... Show MoreTo develop a new basis to reduce the phenomenon of stress, one researcher used relaxation techniques is the use of medicinal herbs sedative which is emphasized by some specialists and researchers because of its direct impact on some of the functions of the body as members have a significant impact on the player from the mental and physical Came the importance of research in the use of medicinal herbs sedative and in particular (Lafracin Black, Plantago Sinani great, Alternen) within the program to soothe the psychological players badminton to get rid of the tension felt by sports by athletic competition through the use of a program to ease the psychological with a range of herbs and both means of calming influence of the nervous system. The
... Show MoreThe drive of this exploration is to investigate the mucoadhesive assets of A. indica (Azadirachta indica) fruit mucilage by incorporating it into mucoadhesive microspheres with Acyclovir (AVR) as a model drug. The study was performed to check the impact of the mucilage proportion on particle size and swelling index. Nine batches of AVR mucoadhesive microspheres were made with varying proportions of Polyacrylic acid 934P and A. indica fruit mucilage (AIFM). A central composite design with design expert software to check the impact of dependent variables (A. indica mucilage and Polyacrylic acid 934 P levels) on particle size and swelling index as a response. As part of congeniality studies, the batches w
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The research dealt with a studying the impact of oil price fluctuations on one of the rules of financial discipline, which is the rule of budget deficit in the Iraqi economy for the period (2003-2020) as it is one of the quarterly economies that rely mainly on volatile oil revenues that fluctuate with oil prices in global markets, and therefore the general budget suffers. from The state of instability and then the government resorts to borrowing for a long time . this deficit in the general budget and increase the debt burden in the public debt.The research aim to measure and study the impact of oil price flu
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