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.
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
... Show MoreThis study aims to identify the role of forensic accounting in the Iraqi environment, banking stability, and to achieve this goal, we used the field survey method, as it is the most appropriate for studying the phenomenon in question and achieving its objectives.
Where we selected a sample consisting of (50) male and female employees, distributed among five private banks in Baghdad governorate, namely (Ashur International Bank, Development Investment Bank, Iraqi Middle East Investment Bank, Hammurabi Commercial Bank, Khaleej Commercial Bank), and the questionnaire tool was applied to them Designed for this purpose, which consisted of
... Show MoreThis study aimed to measure the accounting conservatism and the lemited factors which affected on it in the annual financial reports of insurance companies which listed on the Amman Stock Exchange during the period from 2005 to 2016, these factors were represented by firm age, firm debt and firm size.
Using the market value model (MV) To book value ( BV) Beaver and Ryan (2000) The level of the accounting conservatism was measured. The study found that the insurance companies which are listed on the ASE exercise the accounting conservatism when they were preparing financial reports. And when conducting a process of the test of the affected of the factors (The age of the
... Show MoreThe rapid development of telemedicine services and the requirements for exchanging medical information between physicians, consultants, and health institutions have made the protection of patients’ information an important priority for any future e-health system. The protection of medical information, including the cover (i.e. medical image), has a specificity that slightly differs from the requirements for protecting other information. It is necessary to preserve the cover greatly due to its importance on the reception side as medical staff use this information to provide a diagnosis to save a patient's life. If the cover is tampered with, this leads to failure in achieving the goal of telemedicine. Therefore, this work provides an in
... Show MoreAdministrative procedures in various organizations produce numerous crucial records and data. These
records and data are also used in other processes like customer relationship management and accounting
operations.It is incredibly challenging to use and extract valuable and meaningful information from these data
and records because they are frequently enormous and continuously growing in size and complexity.Data
mining is the act of sorting through large data sets to find patterns and relationships that might aid in the data
analysis process of resolving business issues. Using data mining techniques, enterprises can forecast future
trends and make better business decisions.The Apriori algorithm has bee
The study was conducted to assess the attitude and awareness of a sample of people regarding the indiscriminate slaughter and its effects on health and the environment compared with slaughtering in a slaughterhouse. The sample consisted of 120 persons from six equal professional groups contacted with the butchery labour (livestock keeper, truck driver, butcher, veterinarian, shopkeeper and consumer). The age ranged 22-76 years old, mean 52±10 years, lived ≥ 5 years in the Baghdad city. The results showed that there is a preference for slaughtering inside the slaughterhouse due to the presence of veterinary examination, slaughtering and preparing meat in a healthy, easy-to-clean places, unlike the indiscriminate sla
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