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.
Educational services in Iraq face many problems that have reduced the efficiency of the educational process, as a result of the difficult conditions experienced by educational services in Iraq. This led to the accumulation of these problems and their exacerbation significantly over the years, as there was no fundamental solution to these problems. The study proposes a planning method for managing the educational system in Iraq, especially for the primary and secondary levels, where these negative phenomena are very prominent, especially the deficit in school buildings and the phenomenon of overcrowding in classrooms. &am
... Show MoreThe research aims to identify the importance of using the style of the cost on the basis of activity -oriented in time TDABC and its role in determining the cost of products more equitably and thus its impact on the policy of allocation of resources through the reverse of the changes that occur on an ongoing basis in the specification of the products and thus the change in the nature and type of operations . The research was conducted at the General Company for Textile Industries Wasit / knitting socks factory was based on research into the hypothesis main of that ( possible to calculate the cost of activities that cause the production through the time it takes to run these activities can then be re- distributed product cost
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This research seeks to test the influence of intellectual capital as an explanatory variable and its components (human capital, structural capital, relational capital) and sustainable competitive performance as a responsive variable and its components (reducing service delivery cycle time, rapid response to market demand, increasing customer satisfaction, providing better Quality of service, increasing market share)” through a field study, and here the research problem was diagnosed in an attempt to answer the following question: Is there awareness among the senior management within the private colle
... Show MoreGA Al Omran, AA Noaimi, Z Al Madfai, H Al Hamamy, Journal of the Faculty of Medicine Baghdad, 2012
Cerebral palsy "is one of the diseases that afflict children, and it is a term given to the condition of a child who is exposed to a normal brain injury by accident due to its inability to grow or damage to the cells of the areas responsible for movement and knowledge of strength and balance during the stage of normal development." (116: 1999: 10) Cerebral palsy causes disruption in movement and posture due to damage to brain cells in areas that control and coordinate muscle tone, reflexes, strength, and movement. The degree and location of brain damage varies greatly between people with paralysis, as well as the severity of disability and symptoms, as they fall into severe to very simple, and cerebral palsy is one of the diseases that caus
... Show MoreBackground: Pain is one of the most reported side effects of orthodontic treatment despite the advanced technology in orthodontics. Many analgesics have been introduced to control orthodontic pain including acetaminophen and selective and nonselective nonsteroidal anti-inflammatory drugs. The great concern about these drugs is their adverse effect on rate of teeth movement. Aims: The purpose of this study was to evaluate and compare the effect of acetaminophen, ibuprofen and etoricoxib on pain perception and their influence on the rate of teeth movement during leveling and alignment stage. Methods: Forty patients were evenly and randomly distributed in a blinded way to one of four groups: placebo (starch capsules), acetaminophen 500mg th
... Show MoreThis work presents a five-period chaotic system called the Duffing system, in which the effect of changing the initial conditions and system parameters d, g and w, on the behavior of the chaotic system, is studied. This work provides a complete analysis of system properties such as time series, attractors, and Fast Fourier Transformation Spectrum (FFT). The system shows periodic behavior when the initial conditions xi and yi equal 0.8 and 0, respectively, then the system becomes quasi-chaotic when the initial conditions xi and yi equal 0 and 0, and when the system parameters d, g and w equal 0.02, 8 and 0.09. Finally, the system exhibits hyperchaotic behavior at the first two conditions, 0 and 0, and the bandwidth of the chaotic
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