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 key objective of the study is to understand the best processes that are currently used in managing talent in Australian higher education (AHE) and design a quantitative measurement of talent management processes (TMPs) for the higher education (HE) sector.
The three qualitative multi-method studies that are commonly used in empirical studies, namely, brainstorming, focus group discussions and semi-structured individual interviews were considered. Twenty
The aim of this research is to identify the extent to which the Conventional and Islamic banks are committed to implement the requirements of the corporate governance in its financial reports. In addition to its commitment to transparency and clarity in dealing with the shareholders and stockholders to protect their interests and to determine the impact of the commitment of the corporate governance on assessing the financial performance of the conventional and Islamic banks that participate in Bahrain Stock Exchange.
Since the advent of the sunrise of the immortal message, Islamic legislation has always established justice and the right guidance, and has prevented any perversion, injustice or corruption, with a divine system that called in its course the characteristics of the legislation on its general basis and its ability to develop, progressivity, and paving the way with a collective approach, accompanied by the worldly and moral punishment. When the corrupters went too far, reformers were delayed and values were missed; Mankind has been afflicted with the scourge of injustice and loss, and has lost sight of the approach that the Creator of the world has given to the people of the world, for what would guide them in their affairs sooner and later
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This research worked on identifying the effect of increasing the volume of indebtedness by companies listed on the Iraq Stock Exchange on the trading volume of those companies, and this research included some theoretical concepts related to both debt financing and trading volume, and it represents the research community of the joint-stock companies listed in The Iraq Stock Exchange (the banking sector). As for the research sample, it was deliberately chosen represented by companies with continuous trading without stopping, which reached 10 joint-stock companies, and the period of research was extended during the period 2011-2015, and a set of indicators and financial methods were used In measuring research v
... Show MoreThe great importance of training made it as an investment for the organization, and assert the Quality of performance which support it by prepare the employee to the Current and future Jobs . The Research problem a rounded about How to measure the impact of training based on (ISO 10015) and its effect on the Quality of performance , How to evaluation the results of training to attained the training goals . The Research aims to find out the effects of application of international standard guidelines (ISO 10015) to attained the quality of audit work achieved in the Federal Board of Supreme Audit. The Research sought to achieve a number of objectives cognitive and applied on the basis of four key assumptions, and other su
... Show MoreThe Ilkhanid Mongols (651-756 AH / 1253-1355 AD) were interested in urbanization and construction in keeping with civilized countries and to have an architectural imprint that competed with the neighboring nations. The Ilkhan Öljeitü Muḥammad Khudābandeh (703-716 AH / 1303-1316 AD), known for his love of building and construction, wanted to have a capital that would immortalize his name and history, so he ordered its construction to compete with contemporary cities, and he summoned workers and engineers from all over the world to contribute to its construction. The city has several educational and service institutions such as schools, ribats, khanqas, mosques, hospitals, markets, and baths, as well as a mausoleum for him, which
... Show MoreThe objective of the research is to shed light on the nature of the impact of the activities of the national strategy for poverty alleviation in achieving the goals of sustainable development, and the research problem was represented by Is there an effect of the activities of the national strategy for poverty reduction in achieving the goals of sustainable development? and represents the field of research in the Ministry of Labor and Social Affairs For the years (2012-2016) and the results of the sustainable development goals indicators for the years (2012-2016), the ready-made statistical program (SPSS ver.10) was used to calculate the percentages, multiple linear regression equation, the F test and the R2 coefficient, and the research
... Show MoreBackground: The need of the patient for a more reasonable esthetic orthodontic intervention has risen nowadays. Thus, orthodontists make use of esthetic orthodontic materials like brackets, ligature elastics, and arch wires. The esthetic brackets come as different forms of materials, such as ceramic brackets, which have their stainability remaining as the most important consideration for the patients and the orthodontists. This study aimed to compare the staining effects of various staining materials, including black tea, cigarette smoke and Pepsi, as well as the time effect on the color stability of sapphire ceramic brackets bonded with three kinds of light cure orthodontic adhesives: Transbond, Resilience and Enlight. Materials and Met
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