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 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 MoreThe 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 research seeks to identify the dimensions of creative thinking and its impact on the re-engineering of hotel service operations by analyzing the correlation and impact between research variables as well as comparing the research sample The importance of the research comes from the need to motivate managers the importance of creative thinking among workers in the researched hotels because it is an essential part in the re-engineering of hotel services. To achieve this a questionnaire was designed containing (33) items that include the independent research variables (creative thinking) and the accredited (re-engineering the hotel service) and distributed to a sample of (50) individuals represented by (Commissioner Director, Dep
... 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 .....
Investment in high education is considered to be most important factors of production which the return an individual and social than economic returns found by searching the growing problem of unemployment, especially among youth graduates, where the unemployment rate in 2010 (50%) of these high rates have led to increased migration of scientific minds graduate recently, "to search for job opportunities outside Iraq for not hiring functions and this is in vain" clear "in the human and financial resources lead to structural imbalances in the Iraqi economy. When calculating the correlation coefficient between the graduates and the unemployment rate where it reached (0.21) emerged from the results of
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The Research Includes Two Variables : First , Academic Accreditation with his dimensions ( Educational Context , Educational Inputs , Educational Process , Educational Outputs , Feedback ) , And The Second : Strategic Performance With His dimensions ( Financing , Satisfaction Stakeholders , Internal Processes , Learning And Growth ) , The Research Highlights On The Academic Accreditation System Which Is Considered A Major And Important Systems Can Through Which Administration Of Activities And Programs Institutions Of Higher Education , As This research aims to determine his relationship And The Extent Of Its Effect In The Strategic Performance , And It Includes The Research C
... Show MoreAbstractThe research aims to identify the impact of the different methods in calculating the Items sensitivity coefficient on the standard characteristics of the Criterion-Referenced test in the measurement and evaluation material. The research sample consisted of (35) male and female students, who were chosen by the intentional method. The researcher prepared learning-teaching program in constructing the content of the measurement and evaluation material for non-specialized departments, prepared an achievement test in its equivalent forms, identified the results of agreement between the methods used in analyzing the items of the criterion-referenced test, and compared the standard characteristics of the achievement test, both according to
... Show MoreThe exchange rate is the backbone of any economy in the world, whether developed or developing, where most countries adopted many policies, in order to ensure the stability of the exchange rate of the currency, because of its importance as a link between the local economy and the others ,And it contribute in the achievement of internal and external balance and despite the many different factors that affect it, but there is wide consensus on the effectiveness of the role of spending and the currency window in the exchange rate of the Iraqi dinar, especially in the Iraqi economy, effectiveness As the increase in government spending lead to an increase in the supply of money and increase domestic demand and high pr
... Show MoreIntroduction: We aimed to assess the impact of adhesive and wires types on the tensile bond strength of fixed lingual retainers. Methods: A total of 160 intact bovine teeth were collected, cleaned, stored in 25% sodium hypochlorite, and randomly assigned to two groups based on the adhesive type: a two-step adhesive and a one-step adhesive. Each group was further divided into four subgroups based on the type of lingual retainer wire, which included (A) 8-strand braided stainless steel wire, (B) three-strand titanium retainer wire, (C) stainless steel chain, and (D) fiber-reinforced retainer. A tensile bond strength test was conducted using a universal testing machine at a controlled speed of 10 mm/min. Result: The 8-strand braided stainles
... Show MoreAutorías: Abdulsahıb Mohammed Muneer, Habeeb Sabhan Maytham, Kazim Abed Emad. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 1, 2021. Artículo de Revista en Psyke.