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 purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to
... Show MoreIn order to find the relationship between Helicobacter pylori infection and hematological disease are disorders which primarily affect the blood and blood-forming organs. One hundred and three blood samples were taken for people aged (20-68) years for the period from 10/1/2021 to 1/3/2022, divided into three groups. The first group included 44-person H. pylori-infected with symptoms of infection, the second group had 19-person H. pylori-infected but without symptoms, and the third group included 40 people without H. pylori infection. All studied groups were carried out to measure anti-IgG Ab, Vac A and Ferritin by Enzyme Linked Immunosorbent Assay (ELISA) technique. The statistical analysis indicates a non-significant difference in Vac A (p
... Show MoreThe research aims to know the extent of the impact of the risks of foreign exchange centers represented in the risks of commitment, exchange rate changes and liquidity risks in audit procedures, and accordingly the research will provide an applied framework of knowledge that shows the relationship between the variables addressed, and the importance of the research lies in the light of its presentation of intellectual, cognitive and applied contributions On the risks of foreign exchange centers and audit procedures, the research community is represented in the banking sector. The sample included nine private commercial banks listed in the Iraqi Stock Exchange. The research relied on a time series consisting of four years that extended fro
... Show MoreThis study was conducted in the Department of Employment and Loans at the Ministry of Labor and Social Affairs to indicate the importance and impact of both the empowerment and the functional flexibility in evaluating the performance of the employees. To achieve the objectives of the study, the data was collected through a questionnaire form designed for this purpose based on previous studies. Data obtained for a significant evaluation of the relationship between the components of both the empowerment and the functional flexibility with the components of the evaluation and determining the degree of importance of each component of both the empowerment and functional flexibility for the components of the evaluation by the extractio
... Show MoreImpact strength of self-compacted concrete is a field of interest, mostly when the concrete is produced from sustainable materials. This research's main objective is to clarify the ability to use two types of Portland limestone cement (Karasta and Tasluja) in self compacted concrete under impact loading, further to the economic and environmental benefits of the limestone cement. The impact loading was applied by a low-speed test, using the drop ball on concrete. Moreover, the study reveals the resistance of the grids reinforced concrete to impact loading by using polymer grid, and steel grid reinforced concrete slabs. Mixes reinforced by steel mesh had the highest results, indicating that the steel mesh was more robust because it had
... Show MoreTax revenues are considered one of the important sources of public revenues for the state as one of the tributaries that finance the public treasury to implement development plans. Real estate taxes are one of the sources of obtaining tax revenues in the state, as it follows that there are a number of factors that affect these revenues, which requires the development of necessary solutions and recommendations to address the resulting effects. Accordingly, this research sheds light on tax revenues in general and real estate tax revenues in particular to indicate the extent of their contribution to the total tax proceeds, as the tax proceeds of the real estate tax were analyzed into the total tax proceeds for the years (2017-2021). A numbe
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The research aims to study the impact of the dimensions of fun in the workplace in achieving internal marketing And knowing the type of relationships That link the dimensions of fun in the workplace With each other, None of the researchers mentioned (to the researcher's knowledge) the link between fun in the workplace and internal marketing From this point of view the main objective is determined, which is to study the effect of fun in the workplace in internal marketing, The research was conducted at Al Salam Public Company for Communications and Information Technology The research community was represented by (308) employees of the aforementioned company , Where a random sample was selected tha
... Show MoreRasheed Street has had great importance by the nature of what was seen as being of vital events of a key facility in the Iraqi capital Baghdad since ancient times until now .
And such as cultural and historical memory-rich street for Iraq, pulsating nerve since the beginning of the last century thanks to the commercial and intellectual stature, as well as being a tourist landmark frequented alleys most of the tourists coming to Iraq , which counted for them a source of tourist attraction, given the religious diversity of fungal who excelled by the street, as we find in exchange for his Church of the Virgin Mary, the time which was built in the middle of the Caliphs Mosque towering minarets and promised that the oldest and largest of t
Rapid and continuous developments and changes in the modern business environment in all areas of economic, environmental, social, technology and communications push economic units to search for modern methods and methodologies to produce products at low cost as well as produce products that meet the wishes of customers in terms of quality and environment to maintain their market position, and accounting for the costs of the flow of materials is one of the most prominent environmental management accounting techniques capable of providing information to help produce
Software cost management is a significant feature of project management. As such, it needs to be employed in a project or line of work. Software cost management is integral to software development failures, which, in turn, cause software failure. Thus, it is imperative that software development professionals develop their cost management skills to deliver successful software projects. The aim of this study is to examine the impact of cost management success factors with project management factors and three agile methodologies – Extreme Programming (XP), Scrum and Kanban methodologies which are used in the Pakistani software industry. To determine the results, the researchers applied quantitative approach through an extensive survey on
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