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 subject of the strategic vision is of great importance to all companies because they live in an environment of rapid change in various areas of life. Supports the performance of its operations in a better way, towards appropriate strategic growth and achieving success. The research aims to determine the level of interest of the researched company in the research variables (strategic vision and growth strategy), and the importance of the research came in being an attempt to provide the theoretical and scientific foundations for the research variables (strategic vision and growth strategy). As for the research method, it was relied on the descriptive analytical method, relying on the questionnaire as a means of obtaining data from the
... Show MoreThe research aims to study the basic concepts of the underwriting policy with its various indicators. The researcher studies the underwriting policy with its various indicators (sex, health status, age of the insured, insurance amount, The method of acceptance, payment method, and duration of insurance) where each of these indicators constitute an important factor in the productivity of life insurance policies, where the productivity of life insurance policies face many difficulties because insurance is a service and not a tangible material commodity and its benefits and not current. Therefore, the life insurance company needs to use a prudent underwriting policy so as not to endanger its financial position due to the expansion of the un
... Show MoreLe Petit Prince est apparu en 1943 vers la fin de la vie de son auteur. La mondialité qu'a gagnée ce récit le rend un des livres les plus lus et les plus vendus dans le monde. Cette popularité en fait un des classiques de la littérature française.
En effet la littérature française a un impact profond et direct sur la vie intellectuelle et littéraire dans le monde arabe. La circulation des œuvres littéraires écrites en français a bien influencé les lecteurs arabes soit en langue française soit traduites en arabe. Cette réalité est identique lorsqu'on parle de la réception du Petit Prince ; l'œuvre la plus connue dans le monde entier dès son apparition officielle.
Ab
... Show MoreBackground: Chronic periodontitis is a bacterial infection that result in bone destruction associated with the increasing level of salivary tumor necrosis alpha and interleukin6 that affect Mother-infant bonding status. The aim of the present study was to assess the relationship between the Mother-infant bonding status in mothers with chronic periodontitis in relation to Salivary Tumor necrosis factor alpha and Salivary Interleukin6. Materials and Methods: The selected sample consisted of mothers with chronic periodontitis compared with mothers with healthy periodontium in postpartum period, their age ranged between 30-40 years. Both groups were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed f
... Show MoreThe collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.
Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.
In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t
... Show MoreThis study aims to determine the reasons for the increase in the frequency of sand and dust storms in the Middle East and to identify their sources and mitigate them. A set of climatic data from 60 years (1960–2022) was analyzed. Sand storms in Iraq are a silty sand mature arkose composed of 72.7% sand, 25.1% silt, and 2.19% clay; the clay fraction in dust storms constitutes 70%, with a small amount of silt (20.6%) and sand (9.4%). Dust and sand storms (%) are composed of quartz (49.2, 67.1), feldspar (4.9, 20.9), calcite (38, 5), gypsum (4.8, 0.4), dolomite (0.8, 1.0), and heavy minerals (3.2, 6.6). Increasing temperatures in Iraq, by an average of 2 °C for sixty years, have contributed to an increase in the number of dust storm
... Show MoreRecommender Systems are tools to understand the huge amount of data available in the internet world. Collaborative filtering (CF) is one of the most knowledge discovery methods used positively in recommendation system. Memory collaborative filtering emphasizes on using facts about present users to predict new things for the target user. Similarity measures are the core operations in collaborative filtering and the prediction accuracy is mostly dependent on similarity calculations. In this study, a combination of weighted parameters and traditional similarity measures are conducted to calculate relationship among users over Movie Lens data set rating matrix. The advantages and disadvantages of each measure are spotted. From the study, a n
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