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.
Le 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 MoreIn wide range of chemical, petrochemical and energy processes, it is not possible to manage without slurry bubble column reactors. In this investigation, time average local gas holdup was recorded for three different height to diameter (H/D) ratios 3, 4 and 5 in 18" diameter slurry bubble column. Air-water-glass beads system was used with superficial velocity up to 0.24 m/s. the gas holdup was measured using 4-tips optical fiber probe technique. The results show that the axial gas holdup increases almost linearly with the superficial gas velocity in 0.08 m/s and levels off with a further increase of velocity. A comparison of the present data with those reported for other slurry bubble column having diameters larger than
... Show MoreThe research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.
The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.
The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.
The research started from four main hypotheses to explore correlations and influence between researc
... 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 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 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 MoreBackground: Blood group system and the ability to taste phenylthiocarbamide (PTC) are the most studied traits in human genetics which have been extensively used in describing genetic variations among human populations around the world that may had an effect on dental caries. The aims of present study were to investigate the caries experience among students with different bitter taste threshold in relation to blood type. Materials and Methods: The sample of present study includes dental students female aged19-21 years. The diagnosis of dental caries was done according to the criteria of Manjia et al, 1989 recording decayed lesion by severity (D1-4) MFS. Furthermore, bitter taste sensitivity was measured according to PTC (phenylthiocarbamid
... Show MoreThe aim of this research is to construct a cognitive behavior program based on the theory of Meichenbaum in reducing the emotional sensitivity among Intermediate school students. To achieve the aims of the research, two hypotheses were formulated and the experimental design with equal groups was chosen. The population of research and its sample are determined. The test of negative emotional sensitivity, which is constructed by the researcher, was adopted. The test contains (20) items proved validity and reliability as a reliable test by presenting it to a group of arbitrators and experts in education and psychology. An educational program is constructed based on the theory of Meichenbaum. The test was applied to a sample of (60) second i
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