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 aim of the research is to determine the impact of evaluation of investment projects after the preparation of investment budgets taking into consideration within the investment budgets the concept of competitive strategy, as the harmony between the preparation of investment budgets and competitive strategy will contribute to the success of economic unity and achieve profits well and achieve a competitive advantage. Strategies for economic units because the most important factor to them is the costs produced and the progress of the research problem is focused on "Is it possible to include a strategy of competition, especially within the investment budget when prepared The study concluded that the investment plan prepared by the
... Show MoreOne of the scientific education aims, preparing a student able to keep up with the scientific developments and innovations around him and make him contribute, adapt, investment and continue development. The concepts of nanotechnology from scientific innovation open up an important area of thinking and intervention in the field of chemistry applications in daily life, the technological changes lead to social, political and economic changes which result that the students to have the knowledge, understanding, awareness, appreciation and sense in applications of modern technology for their use optimally, in order to cope with these scientific and technological changes. The research aims at finding out the correlation between the acquisi
... Show MoreThe research aims to identify the impact of managing performance's employees in building intellectual capital, Because employing the practice of managing the performance of employees may acquire familiar skills to improve their performance and reflect on the construction of intellectual capital in the surveyed area, Especially that the independent dimension represented by the management of the performance of employees is one of the important topics that has received attention in the world of management in general and human resource management in particular. While the adopted dimension was represented by Intellectual capital in the important practice of human resource management in the increasing of their knowledge, to
... 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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Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear
... Show MoreThe research aimed at finding out the effect of functional rotation on the tax performance of the employees of the General Authority for Taxes through the five-meter questionnaire prepared according to the required data. The data obtained from the research sample were analyzed. The results showed a significant effect of recycling In the tax performance, and this is evident from the proportion of his contribution to the interpretation of the total variation, which is a good indicator of the impact of functional rotation in the performance of the body sample research.
The research aims to measure and analyze the reality of liquidity in the Rasheed Bank and determine their impact on risk and return in order to identify the extent of the efficiency of the management of liquidity by the Bank and how to employ them in a profitable investment areas, and analysis of the compatibility of the liquidity gap and gap the balance sheet (sensitive interest rate) and affected net interest Change prices, and through the adoption of style ladder recommended Meritassets and liabilities by the Central Bank of Iraq, as it is an important and vital aspects in commercial banks' management, when there is a commonly used optimizing the resources of the bank available, it means that there is a banking efficient management is
... Show MoreThe study area is witnessing divergence where I am North wind North East wind as we find that the north wind is getting replicated as we move from the south, The reason can be attributed to the nature of the surface of the region, with at least repeat this wind the northern region to the presence of mountain ranges, while we find that energizes the surface in the center and south helped to increase repeat this wind gusts, It also finds that the North wind East prevail in the northern region and least replicated as we move from the north to the south and to the fact that North stations are within blowing this wind sites for the circles near the display of high pressure located centers to the north-east, north and distancing itself from pa
... Show MoreThis experiment was conducted in the season 2001-2000 in station Ishaqi the company's general industrial crops to plant livestock Vigna radala deleted (Khadrawi) carried out the experiment design panels splinter and order in RCBD with three balls two factors are levels nitrogen fertilizer (120 and, 100.0 kg urea / ha)nitrogen ratio of 46%, which put in the main panels mAIN PLOT and Alkiavat three levels that were placed in secondary panels .....