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.
An experimental study is carried out on the effect of vortex generators (Circular and square) on the flow and heat transfer at variable locations at (X = 0.5, 1.5, 2.5 cm) ahead of a heat exchanger with Reynolds number ranging from 62000< Re < 125000 and heat flux from 3000 ≤ q ≤ 8000 W/m2 .
In the experimental investigation, an apparatus is set up to measure the velocity and temperatures around the heat exchanger.
The results show that there is an effect for using vortex generators on heat transfer. Also, heat transfer depends on the shape and location. The circular is found t
... Show MoreThe main topic of this study is central around the independence of Jordanian central bank and the extent of the effectiveness at the bank in leading the monetary policy without interferences or pressures from side of the government. the degree of independence of Jordanian central bank was based on the following based hypothesis following ,there is relationship between the independence of the central bank and the legislative and economical indices. the most important recommendations are degree of independence of the Jordan central bank 43.5% is a good one, but it possible to reach a higher degree than this one by to making some modification on the Jordanian central bank law and by the central bank should be more rigid
... Show MoreThe organizational culture is an effective control mechanism that dictates the behavior of employees and according to their intellectual and social orientations, so it is considered a more powerful way to control employee orientations and determine their management according to organizational rules and regulations, as it was one of the most important factors determining the performance of organizations, while organizational performance is a measure of what the organization has achieved from the objectives of the scheme To ensure that it faces various changes and remains within the global competition, and to reach that it was necessary to identify the most prominent and most important research problems in knowing the extent of com
... Show MoreThe research aimed to demonstrate the possibility of benefiting from the coordination between real estate and income tax as the independent variable on the tax outcome as the dependent variable as the dependent variable. Which were practiced within rented buildings, as information was obtained from real estate owners, and the annual controls for the year 2021 were relied upon in the process of calculating the tax amounts expected to be obtained. used in the tax inventory process lacks seriousness and continuous updating
Followers and their followers (may Allah be pleased with them all) followed the approach of the guidance and the Sunnah of the Messenger of Allah Muhammad (peace be upon him) in the collection and codification of the hadith of the Prophet Muhammad in various Arab and Islamic areas. Subsequent judge Faqih Abu Bakr al-Ansari had a distinct effect during that time immortalized in the pages of our Islamic history in preserving the Sunnah of our great Prophet Muhammad (PBUH) and documenting the constants of Sharia and Islamic jurisprudence and its importance in the activity of intellectual and scientific movement in the Arab Islamic State.
The research aims to shed light on the role of E-Audit in raising Independence and professional competence of the external auditor, the study has been applied on a sample of the branches of the Rafidain Bank n have been addressed research topic beside the theoretical, as put forward by the literature of accounting, audit and that the contents of the section first, either the practical side was required to test the hypotheses use form questionnaire, which was distributed to a sample of the external auditors and bankers research sample. He has applied for his part in the search for a standard of independence and professionalism of the external auditor and the factors influencing these standards, and the most import
... Show MoreThe research aims at introducing the principles of six sigma and if it had any effect of the dimensions of six sigma to improve the performance of the dentists and the availability of an appropriate environment in the center Specialist respondent to the application of six sigma principles and how to adopt Specialized Center under the dimensions of the six sigma and if there informed enough with the management methodology six sigma, and if you can adopt six sigma as one of the entrances to reduce medical errors. So Search creating six sigma five dimensions and are (the commitment and support of senior management, the focus on the patient, continuous improvement, training and civil, and infrastructure) as a variable int
... Show MoreABSTRACT
Threw this research to the following:
1 - Know the impact of strategy Puglia in the collection of the rules of the Arabic language
students at the Institute of preparation parameters .
2 - Know the impact of the retention strategy in Puglia collection rules Arabic language
students at the Institute of preparation parameters .
To verify the status Mmermaa Find researcher Elsafreeten following two hypotheses :
1 - There is no statistically significant difference between the average score for the collection
of the fourth grade students at the Institute for the preparation of material parameters who
were studying grammar strategy Puglia and average grades collectible fourth grade
students at the Institu
The world is keeping pace with evolution in all its fields as a result of scientists' pursuit of continuous scientific and technological development. This evolution included the sports field, which had a large space in the aspect of development and for all disciplines, Therefore, it's reflected today in what we see of records and advanced achievements in sporting events and activities. The development in the field of sports was the result of scientific research (Hussein and Jawad., 2022), where the interest in the training process has become one of the most important pillars of the development of achievement (Neamah and Altay., 2020). The shooting sport has also witnessed a remarkable development due to the diversity and development of its
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