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.
This research aims to understand complexity management and its impact on the use of the dynamic capabilities of a sample of private colleges. Private colleges are currently facing many crises, changes, unrest and high competitive pressures. Which is sometimes difficult or even impossible to predict. The recruitment of dynamic capabilities is also one of the challenges facing senior management at private colleges to help them survive and survive. Thus, the problem of research was (there is a clear insufficiency of interest in Complexity Management and trying to employ it in improving the dynamic capabilities of Colleges that have been discussed?). A group of private colleges was selected as a
... Show MoreThe UN plans to achieve several development objectives by 2030. These objectives address global warming, a major issue. This method aims to improve sustainable accounting performance (AP). In this circumstance, AI is being applied in various fields, notably in economic, social, and environmental (ESE) domains. This research investigates how sustainable development (SD) influences AI methodologies and AP improvement. The research examined a sample of Iraqi banks listed on the Iraq Stock Exchange from 2014 to 2022. AI was measured by ATM and POS prevalence. A three-dimensional approach examined economic, social, and environmental (ESE) sustainability. Meanwhile, the performance of sustainable accounting was measured through the return on asse
... Show MoreDiverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost
... Show MoreThe chemical bath deposition technique (CBD) is considered the cheapest and easiest compared with other deposition techniques. However, it is highly sensitive to effective parameter deposition values such as pH, temperature, and so on. The pH value of the reaction solution has a direct impact on both the nucleation and growth rate of the film. Consequently, this study presents a novel investigation into the effect of a precise change. in the pH reaction solution value on the structural, morphological, and photoresponse characteristics of tin monosulphide (SnS) films. The films were grown on a flexible polyester substrate with pH values of 7.1, 7.4, and 7.7. The X-ray diffraction patterns of the grown films at pH 7.1 and 7.4 confirmed
... Show MoreModern communication and media technology has pioneered new horizons and curried out deep changes in the various fields of social life, It effected enormously human communication as well.
Content one Who late the developments which have effected the social relations ،due to the new media ،especially Face book ,will certainly notice the far cry changes of the social relation net which has been effected ,in a way or another ،the accelerated development ،under the appearance of the so called the virtual society .
Face book has embodied the means – communication ,which has become an important turn point in the social communication .
It is the point the present paper tries to expose an discuss by a field study curried on a sam
Background: The type of dental implant surface is one of many factors that determine the success of implant restoration. This study aimed to study the effect of mixture of nano titanium oxide with nanohydroxyapatite coating of screw shaped CPTi dental implant on bond strength at bone implant interface by torque removal test related to two healing periods (2 and 6 weeks). Materials and methods: Dip coating process was performed to get an even coating layer on CPTi screws. X-ray diffraction (XRD) analysis and microscopical examination were performed on the coating surfaces of the CPTi. The tibia of 10 white New Zealand rabbits was chosen as implantation sites. The tibia of each rabbit received two screws, one was coated with mixture of nanoT
... Show MoreIn this work, the geomagnetic storms that occurred during solar cycles 23 and 24 were classified based on the value of the Disturbance Storm Time index (Dst), which was considered an indicator of the strength of geomagnetic conditions. The special criterion of Dst >-50 nT was adopted in the classification process of the geomagnetic storms based on the minimum daily value of the Dst-index. The number of geomagnetic storms that occurred during the study period was counted according to the adopted criteria, including moderate storms with (Dst >-50 nT), strong storms with (Dst >-100 nT), severe storms with (Dst >-200 nT), and great storms with (Dst >-350 nT). The statistica
A detailed experimental study was devoted to the anodic oxidation of oxalic acid using manganese dioxide rotating cylinder anode with the objective to evaluate in a systematic way the effect on the oxalic acid oxidation process of several relevant parameters, including the presence of sodium chloride, the current density (J), the rotation speed, the temperature, and the initial concentration of oxalic acid. Thin manganese dioxide film on graphite substrate has been prepared by electrochemical oxidation from MnSO4-H2SO4 electrolyte. The morphology of this electrode was investigated by XRD, SEM, EDS and AFM techniques. The results show that a firm γ-structure of MnO2 film on graphite rod can be obtained successfully. The results indicate tha
... Show More