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 principle of citizenship has international dimensions that affect the application of the principle, such as the structure of the international system, and the control of the concepts of globalization, international organizations which played an important role in the consolidation of this principle.
The problem of the study revolves around the effects of international variables on the principle of citizenship in Kuwait during the period 1991-2018.
The study used several indicators, such as: the rule of law, achieving the principle of separation of powers, the right to form parties, the application of the law of nationality, and racial discrimination, women's rights, and freedom of expression.
Many people believe that diabetes appears after a psychological crisis, which is a misconception but it could be in them before having a crisis ore the crisis. But emotion increases the appearance of symptoms, and athletes are at risk of developing diabetes. Hypoglycemia is not unusual for athletes, and during physical activity the sugar level changes in the blood. Therefore, it is important to conduct tests for the measurement of sugar before and immediately after the activity, for the purpose of detecting the sharp drop in the sugar level and treating it, and the early detection is necessary to avoid the possibility of diabetes, the concept of psychological immunity in psychology is considered a positive concepts that maintain the balance
... Show MoreAbstract- Plasma parameters in a planar dc-sputtering discharge in argon were measured by cylindrical electrostatic probe (Langmuir probe).Electron density, electron temperature, floating potential, and space potential were monitored as a function of working discharge pressure. Electrostatic probe and supporting circuit were described and used to plot the current – voltage characteristics. Plasma properties were inferred from the current-voltage characteristics of a single probe positioned at the inter-cathode space. Typical values are in the range of (10-16 -10-17) m-3 and (2.93 – 5.3) eV for the electron density and the electron temperature respectively.
Artificial roughness on the absorber plate of a Solar Air Heater (SAH) is a popular technique for increasing its effective efficiency. The study investigated the effect of geometrical parameters of discrete multi-arc ribs (DMAR) installed below the SAH absorber plate on the effective efficiency. The effects of major roughness factors, such as number of gaps (Ng = 1-4), rib pitch (p/e = 4-16), rib height (e/D = 0.018-0.045), gab width (wg/e = 0.5-2), angle of attack ( = 30-75), and Reynolds number (Re= 2000-20000) on the performance of a SAH are studied. The performance of the SAH is evaluated using a top-down iterative technique. The results show that as Re rises, SAH-effective DMAR's efficiency first ascends to a specified value o
... Show MoreBackground: to evaluate the effect of different dentifrices on the surface roughness of two composite resins (nanofilled-based and nanoceramic – based composite resins). Materials and methods: Forty specimens (diameter 12 mm and height of 2mm) prepared from different composite resin materials: Z350 (nanofilled composite, and Ceram-X (nanoceramic) .they were subjected to brushing simulation equivalent to the period of 1 year. The groups assessed were a control group brushed with distilled water (G1), Opalescence whitening toothpasteR (G2), Colgate sensitive pro-relief (G3) and Biomed Charcoal Toothpaste (G4). The initial and final roughness of each group was tested by surface roughness tester. The results were statistically analyzed using
... Show MoreThe tax revenues achieved through projects of transition to private sector are regarded as an important source for using in achieving political, economic and social objectives. Since Iraq is heading towards free market economy, new strategies should be adopted to reform the taxation system from by a qualified taxation management office and to activate the taxation policy and to reconsider legislation in relation to the aware of the legible to the importance of disclosure of their taxable real income in order to arrive at contribution of privatization in the taxation revenues for the important role effect on economic activities. In the light of the above, the research is based upon a hypothesis which stipulates that privatization contribu
... Show Morea-Ge: As thin films have prepared by thermal evaporation teclmique, then they were annealing at various temperatures within the
range (373-473) K. The result of X-ray di ffraction spectrum was showing that all the specimens remained in amorphous structure before and after annealing process. This paper studied the effect of annealing temperature as a function of wavelength on the optical energy gap and optical constants for the a-Ge:As thin films . Results have showed that there was an increasing in the optical energy gap
{Egopt) values with the in ,;rcasing of the annealing temperatures within
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