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.
ھدف البحث الـــــى : ١ -إعداد تدریبات القوة الارتدادیة في وسطین متباینین على بعض المؤشرات الفسیولوجیة لتطویر القوة الانفجاریة ودقة مھارتي الأرسال والضرب الساحق بالكرة الطائرة . ٢ -التعرف على تأثیر تدریبات القوة الارتدادیة في وسطین متباینین على بعض المؤشرات الفسیولوجیة لتطویر القوة الانفجاریة.. ٣ -التعرف على تأثیر تدریبات القوة الارتدادیة في وسطین متباینین على دقة مھارتي الأرسال والضرب الساحق بالكرة الطائرة
... Show MoreMoisture damage is a primary mode of distress occurring in hot mix asphalt (HMA) pavements in Iraq. Because of the loss of bond, or stripping, caused by the presence of moisture between the asphalt and aggregate, which is a problem in some areas and can be severe in some cases, it is requires to evaluate the design asphalt mixture to moisture susceptibility. Many factors such as aggregate characteristics, asphalt characteristics, environment, traffic, construction practices and drainage can contribute to stripping. Asphalt concrete mixes were prepared at their optimum asphalt content by superpave system and then tested to evaluate their engineering properties, which include tensile strength, resilient modulus, and perman
... Show MoreIn this research a study process to calculate the factor accumulation of gamma rays for aluminum and exporters cobalt 60 Mika Atktron volts and actively radiation Vdrh 1.406 Mika Bq been studying the effect of the angle of reimbursement and the distance between the shield and detector In measurements factor accumulation Adhrt results in line with the theoretical results published
It is no secret to everyone that the Arab individual suffers from poor self-awareness and political awareness, which made the state and the importance of its existence and preserving its institutions not among his interests, which made researchers wonder about the possibility of strengthening it and the extent of its impact on the future of building the contemporary Arab state. So, the study attempts to addressing the issue of community awareness and its impact on building the state through a clear intellectual vision that blended what is social and political to define the concept of community awareness and highlight its importance and role as a basic pillar in shaping and building modern Arab countries in the Arab world and ways to enha
... Show MoreThe UN organization is considered one of the most important organizations at the international level. It has accomplished multiple tasks and roles of many different issues and events that hit the developing and advanced world countries. It has performed a series of procedures and laws that have had an impact on ending the wars and conflicts that plagued some countries and continued for a period of time in the past. Moreover, it has improved the level of the international relations between a number of countries due to the problems and incidents took place between them. It has relied on finding solutions and treatments for humanitarian problems such as the preservation of the environment, preventing the spread of epidemics and diseases Thi
... Show Moreالغرض - تعتمد هذه الدراسة على المنهج الوصفي التحليلي من خلال جمع البيانات اللازمة وتحليلها، كون هذا المنهج يركز على استطلاع الآراء لعينة البحث وتوجهاتها ، وتهدف إلى تطوير نموذج يدرس العلاقة بين خلق المعرفة والبراعة التنظيمية في المصارف الخاصة العراقية والتحقق من صحته تجريبياً. التصميم / المنهجية / المدخل- تم إجراء مسح عبر استمارة استبيان لجمع البيانات من عينة من (113) مدير من مصارف تجارية خاصة بالإضافة إلى ذلك ا
... Show MoreA study on solvent extraction of Tellurium with Anthranilic acid in
water has been made. The effect of different parameters such as type of medium, time of equilibration, concentration of metal ion, solvent polarity and effect of anions and catins distribution ratio of tellrim (IV) were evaluated. The stoichometric ratio of the extracted species is determined by using two methods suh as slope analysis and mole ratio method and found to be (M: L) (1:4). The instability constant of complex was calculated as well.
Background: Uncontrolled hyperphosphatemia is the main difficulty facing staff treating patients with end-stage renal disease on hemodialysis. Sevelamer and calcium-containing phosphate binders have been associated with cost burden and tissue calcification, respectively. Therefore, the current trial was targeted to investigate the efficacy of a new phosphate binder, ferric citrate, in a sample of Iraqi patients with end-stage renal disease on hemodialysis. Keywords: Ferric citrate, Hemodialysis Phosphate binder
This research aims to study to the strategic management of organizational conflict, which included (concept of conflict and development, types Altzimi conflict, ,management strategies organizational conflict) and its impact on job performance, which included( the concept of performance, elements functionality,) As well as the impact of the conflict on job performance has been selected Rashad training Hospital affiliated to the Department of Health in Baghdad's Rusafa, as the most important service hospitals with the exact specialty in psychiatry and its impact on the lives of citizens and how to enable the hospital aware of the strategic management of organizational conflict raises the level of functionality provided and make the
... Show MoreThe trade war, of course, leads to a sharp tension in international relations because the economy is the lifeblood of the states. In the world of trade and economy, countries began to lean towards cooperation. Economic relations after World War II were more liberal, trade barriers were removed and global trade became more flexible and smooth