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 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 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 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 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 MoreTh paper scientifically deals with the Syrian crisis events erupted in 2011 using the historical descriptive and analytical approaches. The importance of the paper comes from the serious crisis that occurred in a region rich of historical crises, and natural resources attracting the attention of the major countries. The paper aims to show the Syrian crisis, its importance to Russia, the United States, and the regional countries, its impact on Russia economically and politically after the intervention, and Russia’s achievements on a global level holding the influential power on international decisions and other global events. The new Russian strategy has proven its worth in preserving its strategic interests as it could help the Syrian
... Show MorePurpose: The research aims to explore the impact Business Intelligence System (BIS) and Knowledge Conversion Processes (KCP) in the Building Learning Organization (LO) in KOREK Telecom Company in Baghdad city.
Design/methodology/approach: in order to achieve the objectives of the research has been the development of a questionnaire prepared for this purpose and then has tested the search in the telecommunications sector, representatives of one of the telecommunications companies in Baghdad city, has therefore chosen KOREK Telecom company as a sample for research, and the choice was based on the best standard international companies to serve mobile communications in terms o
... Show MoreThe study aimed at ideutifying the impact of scieutific skills in strategy and liabits of mind amony stueuts in tenth grade . The study demanded to choose a sampie that coutaiun (42) student of the fourth grade of the secondary school who were dirided into tow groups , the first is experimental studied according to scieutific skill strategy , and the other controlling , studied according to the usualway . An achievement test has been taken that adopted staudard for mind skills as research tools that are applid after ascertaining sincerity proved at the end of the experiment .The study has reached to the conclusion that there are statistically significant differnces in farour of the experiment group in both
... Show MoreInvestments in shares represent an essential component of companies’ assets and a source of profit making resources. These investments are linked to the areas of trading and speculation, which is reflected on their market value, which makes accounting for and evaluating these investments require their own accounting standards, and thus several international standards were issued regarding this as well as a statement of their impact on growth Sustainable, as the research problem is to show the impact of measuring investments in shares according to international accounting and financial reporting standards on the sustainable growth of economic units, the research sample and its reflection on audit procedures. In accordance with i
... Show MoreBackground: A worldwide health epidemic, type 2 diabetes mellitus was significantly influenced by chronic inflammation, which led to increased insulin resistance (IR). The most widely practiced form of therapy used to control musculoskeletal pain in people with diabetes is non-steroidal anti-inflammatory drugs (NSAIDs), which provide their action by inhibiting cyclooxygenase enzyme (COX). COX1, COX2, and COX3 are distinct isoforms of the cyclooxygenase enzyme. The potential anti-inflammatory benefits of cyclooxygenase-2 (COX-2) inhibitors, both selective and non-selective, have been investigated concerning the management of type 2 diabetes patients. Objective: the purpose of this research is to explore the impact of highly selective
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