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.
Many letters and theses written on the subject of consensus, as well as in measurement,
But we tried to address a topic of consensus
Building a blind measuring guide.
We have tried to explain the meaning of convening, then the statement of consensus in language and terminology and then the statement of measurement
Also, we have shown the types of consensus mentioned by the jurists, and this is how much was in the first topic, either
The second section included the statement of the doctrines of the blind in the matter, and then the evidence of each doctrine and discussed.
We followed it with the most correct opinion statement and concluded the research with some of the conclusions we reached through
search.
This study has been undertaken to postulate the mechanism of impact test at low velocities. Thin-walled tubes of 100Cr6 were deformed under axial compression. In the present work there are seven velocities (4.429,4.652,5.240,5.600,5.942,6.264, 6.569) m\sec were applied to show how they effect the load, change in length, also the kinetic energy. However, the comparison between the obtained results and the other studies (Alexandar[3] , Abramowicz[4], Ayad[5]) was made the present work and Ayad data show good agreement. Load, change in length, kinetic energy were determined to understand the impact test.
Flexible paving is the most popular type of paving used in road building and one of the biggest problems facing the world's paving business is the rising demand for scarce natural resources. Uncontrolled. Numerous studies have shown that secondary materials reduce the need for traditional materials, offer efficient waste disposal technology and lower the overall cost of paving. The current study aimed to evaluate the efficiency of both fibers and dust on the sustainability and cost of flexible pavement by studying each of polyester fibers as a waste of the textile industry and fibers or rubber particles as one of the rubber waste products, in addition to studying the efficiency of using cement dust and marble dust on the paving proc
... Show MoreThe current research problem is focused on the level of human resource managers' performance of their contemporary roles and the impact of this on achieving organizational excellence. The research aims at diagnosing and interpreting the nature of the relationship between the roles of human resource manager and organizational excellence. ), And oil companies located in Baghdad governorate. The research included (boards of directors), and collected data from (83) respondents representing the research community exclusively and comprehensively
represented in the positions of function (Directors-General, Associate Directors-General, heads of departments, divisions and divisions). (49) questions, as well as th
... Show MoreAbstract
The cultural contrast is considered of the essential subjects in the field of administration of international businesses which have great and effective role for representation in one social system for the individuals have various belongings, and the nursing performance is considered an essential basic for health care, thus a discussion for two variables have done to formulate the intellectual frame for this research which are( the cultural contrast and the nursing performance). depended a questionnaire as a research tool by(90) he/ she nurses of the Iraqis and the arrivals( the
... Show MoreDrug consultation is an important part of pharmaceutical care. mobile phone call or text message can serve as an easy, effective, and implementable alternative to improving medication adherence and clinical outcomes by providing the information needed significantly for people with chronic illnesses like diabetes and hypertension particularly during pandemics like COVID-19 pandemic.
The concept of Assemblage appeared obviously in Postdramatic works, where a character or a text may stand as an assemblage of potentialities in the sense that it signifies unidentified subjectivity. Assemblages are constituted essentially of heterogeneous elements yet fused without specific demarcations. In order to enjoy the desired productivity at a "smooth pace," the regularities of political and societal institutionalization are disseminated. To achieve this dissemination, Deleuze-Guattari suggest an unsatiated platform of a "Body without Organs' (BwO), where desire escapes identification. Martin Crimp (b. 1956) defines his off-stage characters in Attempts on Her Life (1997), Anne, or whatever the name is, as a 'BwO', upon which
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