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.
Portland cement concrete is the most commonly used construction material in the world for decades. However, the searches in concrete technology are remaining growing to meet particular properties related to its strength, durability, and sustainability issue. Thus, several types of concrete have been developed to enhance concrete performance. Most of the modern concrete types have to contain supplementary cementitious materials (SCMs) as a partial replacement of cement. These materials are either by-products of waste such as fly ash, slag, rice husk ash, and silica fume or from a geological resource like natural pozzolans and metakaolin (MK). Ideally, the utilization of SCMs will enhance the concrete performance, minimize
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Today, the financial and banking sector is witnessing a qualitative shift thanks to financial technology services, which provide their services to many individuals and companies in quick, easy and less expensive ways compared to traditional means. Financial technology is a new form of financial science that combines financial transactions and technological skills concerned with providing financial services and improving the work environment within Banking institutions, and financial technology provides many advantages such as lower transaction costs, instant payment, and saving more time and effort in conducting banking
... Show MoreThis research examines the impact of cornering on the aerodynamic forces and stability of a Nissan Versa (Almera) passenger sedan car by introducing novel modifications. These modifications included single inverted wings with end plates as a front spoiler, double‐element inverted wings with end plates as a rear spoiler, and incorporating the ground as a diffuser under the car trunk. The goal is to enhance the performance and stability of conventional passenger cars. To ensure the accuracy of the numerical data, the study utilized multiple methodologies to model the turbulence model, ultimately selecting the most suitable option. This involved comparing numerical data with wind tunnel experimental d
Abstract : This research has tackled about the role of Russia in the international policies which concerning with energy , So the most important states in the world that possesses huge energy resources to be more able in the control over the reality and future production programs and the distribution of global energy alike , the latter had effectively influence on the economic and developmental aspects within many countries in the world and its impacts on political decisions and perhaps effected too much in the dimensions of strategic policies . In this context of research , Russia has been developed a high energy policy of strategic planning in order to restoring Russia position and its global role by using its potential powerful streng
... Show MoreThe Urban Residential has developed and changed in different periods of time with successive and gradual shifts, as it cast a shadow over the characterization of modern urbanism in Iraq. The semi-total absence of the governing legislation of urbanization as well as the weakness of the State's role of supervisory in addition to neglecting urban heritage contributed in offering a strange environment in relation to its traditional identity. That was increased by the pressure of the using urban environment as a result of the increasing of population as well as the growth of people’s needs. The research aims to provide an objective view for a mechanism of the application of urban legislation to monitor the implementation o
... Show MoreThis study aims to identify the concepts of financial crisis and its reasons of creation , also explain the effects of the accounting disclosure and the International Accounting Standards in current financial crisis, In addition to, indicate the role of accounting in the reform of the financial system from the impact of financial crisis.
The methodology of this study orientied to two main aspects, the first is an identifying approach through exploring the opinion of financial experts, the second aspect is based on an analytical approach to satisfy the requirements of experts to get there opi
... Show MoreBackground: Failure of resin bases were a major disadvantage recorded in the constructed dentures. Reinforcements of the repair joint with nano fillers represent an attempt to enhance the strength and durability. The purpose of the research was to estimate the influence of nano fillers reinforcement with (ZrO2 and Al2O3) on impact and transverse strength of denture bases repaired with either cold or hot processing acrylic resin. Materials and methods: A hundred and forty (140) samples were processed with hot cured resin and organized in subgroups depending on the repair materials and condition (without repair (control), repair with hot cure, cold cure, hot and cold cure reinforced with either (5% Zr2O or 0.5% Al2O3). The samples in these
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