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 research aims to apply the activities of the green value chain as one of the modern administrative techniques that economic units resort to develop solutions to the pollution problems that occur due to the activity of economic units and their products that may cause damage to the environment as well as the waste of natural resources and to identify the production of environmentally friendly products and reduce the costs of environmental failure of both types Internal and external that may be borne by economic units such as taxes, fines and compensation due to non- observance of environmental requirements and the preservation of human health and protection of the environment.To achieve the goal of the research, the researchers re
... Show MoreThe current research aims to verify the impact of digital leadership as an independent variable, in the effectiveness of crisis management as a response variable through centralizing strategic vigilance in the faculties of the University of Baghdad and its departments, and to investigate the level of interest of its leaders and subordinates in research variables, as well as coming up with recommendations that contribute to strengthening the practices of the three variables. In the university under study, and based on the researcher’s interest to diagnose the influence relationship between the variables, because of their importance in the university’s headquarters and its members on the one hand, and its refl
... Show Moreأن كرة السلة بما تتضمنه من مهارات حركية متنوعة تتطلب من ممارسيها امتلاك عدد من القدرات الحركية الخاصة وبشكل خاص التوافق العضلي العصبي والرشاقة والقوة المميزة بالسرعة، فضلاعن قدرات الإدراك الحس- حركي (إدراك المكان وقوة دفع الكرة سواء بالطبطبة العالية أو الواطئة .... الخ ) لذا تكمن أهمية البحث في إيجاد الطرق والوسائل التي تطور قدرة الطالبة على إدراك قوة دفع الكرة والإحساس بها أثناء تعلم وتدريب الطبطبة بأنواعها ب
... Show MoreOur research subject (environmental impact in the cultural output of the civilizations of ancient East) the environmental impact on human civilization and how her and adapted to serve in various cultural aspects especially in ancient cultures whether punches or sculptures and other addresses as well as tracing precious stones and raw materials. It was the environment of the civilizations of Mesopotamia and Egypt and another effective impact in drawing ancient history through human interaction and responsiveness. The Iraqi environment was marked by poverty and cruelty on the one hand and on the other cultural elements contributed to the civilization in General and research dealing with technical and product sourcing raw materi
... Show MoreThis search that addressed with (( The Impact of Cultural Dimensions in multicultural Project Teams )) tagged is important variables in the project environment that rare has been adverted in Arabic studies . The search problem is reflected in missing of awareness towards a cultural dimensions of the Diyala bridge area project team and their impact in project communications ، as well as weak project management interest in adopting a clear and scientific approach in the management and organization of project communications in order to reach the objective of the study ، was used questionnaire that built depending on previous global studies and has been adapted to accommodate Iraqi business e
... Show MoreThe research aimed to investigate the level of Organizational Cynicism and Job Engagement of Government Schools teachers in Al Zubair district. To achieve this research was conducted on a random sample of (66) items. The statistical package for social sciences (SPSS) was used to analyze and examine the hypotheses. The researcher used many statistical methods to achieve the research objectives, such as simple, multi regression and the research results showed there is a significant impact to teacher's in the schools of the research sample between Organizational cynicism and Job Engagement
The ultimate goal of any sale contract is to maximize the combined returns of the parties, knowing that these returns are not realized (in long-term contracts) except in the final stages of the contract. Therefore, this requires the parties to the contract to leave some elements open, including the price, because the adoption of a fixed price and inflexible will not be appropriate to meet their desires when contracting, especially with ignorance of matters beyond their will and may affect the market conditions, and the possibility of modifying the fixed price through The elimination is very limited, especially when the parties to the contract are equally in terms of economic strength. Hence, in order to respond to market uncertainties, the
... Show MoreInformation security is a crucial factor when communicating sensitive information between two parties. Steganography is one of the most techniques used for this purpose. This paper aims to enhance the capacity and robustness of hiding information by compressing image data to a small size while maintaining high quality so that the secret information remains invisible and only the sender and recipient can recognize the transmission. Three techniques are employed to conceal color and gray images, the Wavelet Color Process Technique (WCPT), Wavelet Gray Process Technique (WGPT), and Hybrid Gray Process Technique (HGPT). A comparison between the first and second techniques according to quality metrics, Root-Mean-Square Error (RMSE), Compression-
... Show MoreThe world is currently challenging the serious effects of the pandemic of the Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Data on pediatric COVID are rare and scattered in the literature. In this article, we presented the updated knowledge on the pediatric COVID-19 from different aspects. We hope it will increase the awareness of the pediatricians and health care professionals on this pandemic.