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 impact of mental training overlap on the development of some closed and open skills in five-aside football for middle school students, Ayad Ali Hussein, Haidar Abedalameer Habe
Abstract
Most of the industrial organization in the world became suffering from the problem of the pollution of the poisonous chemicals things, this urged to depend on the principle of the responsible production, because it has the positive role by dealing with these chemical things and to safe the health of the society, due to the main goal of this study is to restrict the role responsible production in accomplishing the system of the environmental management through an actual study in the northern gas company in Kirkuk province, the topic has acquired a big importance bacause there were a limited number of studies and res
... Show MoreThe main aim of the research is to identify the impact of the application of IFRS for SMEs on optimizing the utility of information for financial reports. To answer the questions and test the hypotheses of the research, researchers relied on the descriptive analytical approach. First, the researchers clarified the theoretical aspect through previous studies, and then they analyses d the results of the applied study by testing the hypothesis using the SPSS.
A questionnaire was distributed after evaluation and arbitration by a number of specialists on selected sample. The sample of 120 respondents consists of general managers, department directors, head of departments, accountants, auditors and financial controllers working in the
... Show MoreThe aim of the research is to measure the length between the variable the efficiency of the tax examiner with its dimensions represented by (scientific questions, practical process (experience), training and development, impartiality and independence, ethics of the profession) and the approved variable discovering the artificial adaptation of profits, and the degree of arrangement of those dimensions its importance and priority, and the research problem has been identified In a main question that is there any effect of copying the images of the image examiner in discovering the adaptation, the financial statements and reports of the companies (X, Y) and the banks (A, B) were relied on in the interpretation of the results, t
... Show MoreIn this research, we sought to identify the nature of the relationship between the exchange rate of the Chinese yuan and the value of Chinese exports, through the formulation of a standard model based on the model of common integration, and based on the data of the study and using the test "Angel-Granger" It reflects the relationship between the two research variables, through which the relationship between the RMB exchange rate and the value of Chinese exports was estimated during the period 1978-2017.
The exercise of citizenship behaviors and their impact on customer loyalty (An analytical study from the perspective of workers in the National Insurance Company).
The Research aims to find out the degree of customers National Insurance company for customer citizenship behavior and its impact on the level oh loyalty from the perspective of employess in the company, as well as the statement of the differences in the answers of employees according to their personality traits. To achieve the goals of research has been the use of the questionnaire as a tool for the collection and distribution of data on a sample of (90) individuals, as was the use of statistical program (SPSS) in the process of statistical analysis methods (mean, sta
... Show MoreThe 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
This 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 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
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