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.
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 MoreResearch aims to know the impact beyond the defined in the collection. The research community is the second school students at Baghdad University and a research sample (63) students, the number of experimental group (27) students and a control group (30) students. The researcher was rewarded in variable lifetime for students and educational attainment and educational level of the parents and the educational level of mothers. The researcher has developed a test took the number of paragraphs (20). A test was true after it has been submitted to the Group of arbitrators. The test was consistent with test method used and the reliability coefficient (0, 88). Either the statistical methods used by the researcher are: Pearson correla
... 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 MoreThe clinical spectrum of cutaneous leishmaniasis (CL), an intracellular parasitic pathogen, ranges from a single sore healing to chronic crusty lesions with a manifestation of treatment resistance. The complicated interaction between Leishmania bodies and the early immune response, including innate and adaptive mechanisms, determines the evolution of nodules. This study examined the levels of the chemoattractant interleukin 8 (IL-8), pro-inflammatory nitric oxide (NO), and immunoregulatory macrophage inhibitory factor (MIF) in the serum of subjects recently diagnosed with cutaneous leishmaniasis, in parallel with patients being monitored during consecutive sodium stibogluconate (Pentostam) treatment. A total of 161 serum samples of newly di
... Show MoreResearch includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.
The importance of research Focus on the evaluation of received projects from contractors executing the projec
... Show MoreThe development of new building materials, able of absorbing more energy is an active research area. Engineering Cementitious Composite (ECC) is a class of super-elastic fiberreinforced cement composites characterized by high ductility and tight crack width control. The use of bendable concrete produced from Portland Limestone Cement (PLC) may lead to an interest in new concrete mixes. Impact results of bendable concrete reinforced with steel mesh and polymer fibers will provide data for the use of this concrete in areas subject to impact loading. The experimental part consisted of compressive strength and impact resistance tests along with a result comparison with unreinforced concrete. Concrete samples, with dimensions of 100×
... Show MoreThe research aimed to study the financial markets liquidity and returns of common stocks , Take the research the theoretical concepts associated with each of the liquidity of financial markets and returns of common stocks , As well as the use of mathematical methods in the practical side to measure market liquidity and Stocks Return, the community of research in listed companies in Iraqi stock exchange that have been trading on its stock and number 85 joint-stock company, The research was based to one premise, there is a statistically significant effect for the liquidity of the Iraqi stock exchange on returns of common stocks to traded companies in which , Using th
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