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 goal of this research is to find the effects of both the studying students groupwhich has various educational levels and the integration of the fragmented information through or during the study of history subjects for the female students of the fifth secondary literary section.
To achieve this study or case the researcher has chosen an experimental design or test by studying three groups: two are as mentioned above and the third is just ordinary team. In addition to that, there is a test after the experiment. The researcher chose on purpose female students of the literal section from two different secondary school Al Asil and Wahran both are secondary school for girls, and both are from directorate of education- Al Karkh 2nd dist
The development that solar energy will have in the next years needs a reliable estimation of available solar energy resources. Several empirical models have been developed to calculate global solar radiation using various parameters such as extraterrestrial radiation, sunshine hours, albedo, maximum temperature, mean temperature, soil temperature, relative humidity, cloudiness, evaporation, total perceptible water, number of rainy days, and altitude and latitude. In present work i) First part has been calculated solar radiation from the daily values of the hours of sun duration using Angstrom model over the Iraq for at July 2017. The second part has been mapping the distribution of so
The understanding exchange rate policy is fundamental in order to identify the mechanism by which works out macroeconomic, And the vital for macroeconomic analysis and empirical work to differentiate between the de facto regimes and de jure regimes, Where the proved surveys and studies issued by the international monetary fund that there is divergence between the de facto regime (Regime of exchange applied by the country actually) and between the de jure regime (Regime de jure through the documents and formal writings of officials of the central bank), And launched studies on the de facto regime (Being a the basis of evaluating monetary policy) Stabilized (peg-like)arrangements or
... Show MoreThis study proposed using color components as artificial intelligence (AI) input to predict milk moisture and fat contents. In this sense, an adaptive neuro‐fuzzy inference system (ANFIS) was applied to milk processed by moderate electrical field‐based non‐thermal (NP) and conventional pasteurization (CP). The differences between predicted and experimental data were not significant (
The Contemporary Business Environment is Surrounded by many quick and continues variable and changes which has an effect on the economic units. These variables and changes like the high competition which need many tools to help them to continue and achieve The critical success. So to achieve this they have many competitive strategies like cost leadership strategy, differentiation strategy and focus strategy.
Budget is regarded one of main tools to execute objectives polices and programs of the economic units, beside show how the economic units had execute the available economic resources.
Activity based on budgeting is regarded one of the modern technique in the m
... Show Moreتحتل أدوات السياسة المالية (الإنفاقية والإيرادية) مكانة مهمة بين أدوات السياسات الاقتصادية الأخرى لما تتمتع به من تأثيرات اقتصادية واجتماعية على مجمل النشاط الاقتصادي .
وفي بحثنا هذا سنركز على الآثار الاجتماعية لأدوات السياسة المالية (الإنفاق العام والإيراد العام) لما للتنمية الاجتماعية من أهمية متزايدة في عالمنا اليوم خاصة فيما يتعلق بمقوماتها غير المادية المتمثلة في خدما
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financial market occupy very important place in the economic activity all over the world countris, and its importance increased with considerable technological progress in the world of transportation ,communications and information where its impact have spread over the whole world, which led to link the international economy in a kind of international relations so that the open policy became the prevailing trend in national and regional economies within the framework of the new world order.
the international economy has faced the financial crisis, global, that hit all world economies although the United States is the center of the crisis and the starting spark for it w
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The research study about the empowerment as an independent variable, in which details include (training and improvement, incentives, information sharing, trust, and delegation), has also focused on the performance of the service organization as a dependent variable in all dimensions which include (improve work efficiency, building the core competencies, focus on the beneficiary of the service, increasing the feeling of satisfaction of the employees, and the organizational support commitment). The research has been based on the opinions of a chosen sample of 75 service officers of the Ministry of Interior who work at the General Directorate of Traffic. The research problem has been identified by t
... Show MoreThe purpose of this paper is to recognize the impact of database levels on fields of banking service (provision of remittance services and transfer of funds, save financial deposits, provision of personal loans services) in some of Iraqi banks using one-way multivariate analysis of variance. The paper population consisted of (120) employees, then a random stratified sample of (104) employees was taken. A questionnaire paper consists of (24) items were designed in order to analyze by one-Way multivariate analysis of variance (MANOVA) using SPSS.One of the main findings of the current paper is that there is an impact of database on fields of banking service in Iraqi banks (Al Rafidain and Al Rasheed).