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.
Using orbit- motion limited theory, as the exact theory in calculating the ion and electron current in dusty plasma, the variations of charge number on a dust grain in Ar-plasma are studied by changing various charging parameters. Most of dependences of charge number on plasma parameters in this paper take into account the close packed effect.
Abstract: The researcher aims to highlight the historical frames of political development in royal regime era (1921-1949) and study its transitions on social-political aspect for the various periods during this consistent era of Iraq history. As some elements played an important role in shaping this era’s features ,as well as 2hat succeed it, which mainly affected the political progression’s configuration, such as : political culture role, social and cultural foundation, state policy essence and the unofficial institutions remarkable role in influencing public awareness and concerning it's relation to the state ,the clan and religious institutions. The researcher employed Alexis de Tocqueville’s evaluation criteria and indi
... Show MoreA recent study compared experimentally the hydraulic and thermal activity of twisted tape inserts for two types, metal foam twisted tape (MFTT) and traditional twisted tape (TTT), in a double pipe heat exchanger. The investigation goal of the innovatively designed MFTT is to enhance the heat transfer process, which provides a higher thermal enhancement factor over those of TTT under the same conditions. Heat transfer activity in terms of Nusselt number (
The aim of the present study was to demonstrate the possible role of statins on the inflammatory biomarkers in patients with periodontal disease (PD) This cross-sectional study involved 74 patients with PD and/or dyslipidemia divided into Group A: 34 patients with PD (nonstatins users); Group B: 40 patients with PD (statins users); and Group C: 30 healthy controls. Total cholesterol (TC), triglyceride (TG) and high-density lipoprotein, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and malondialdehyde (MDA) were measured . Blood pressure prolife and indices of PD were evaluated in each group. Statistical analysis was conducted by using SPSS version 20.0.
This study research to Showing The impact of the integration process on the quality of Insurance service and analyze the impact financially to determine whether there is any impact on the quality of the insurance service, in addition to identifying the obstacles that impede the merger between the insurance companies, insurance and the appropriate proposals for its' application and benefit from the benefits achieved.
The importance of The study lies in the fact that it is an important and vital spotlight that is becoming increasingly important in the world to confront the various difficulties and crises that have occurred recently in light of the liberalization of international trade, globalization a
... Show MoreTook apple branches Genuine and Architecture tissue cultured in vitro 3 cm long and planted in the middle of food MS that contains different concentrations of inorganic salts and of Mntmat free growth and incubated Transplanter to study their effect on rooting Aalavra
Abstract
Despite the fact of the importance and effectiveness of supporting the pricing policy for agriculture sector in Iraq, but this policy has stopped in supporting those agriculture production needs, and it was confined to support the final product only, and supporting the strategic corps exclusively after the U.S. Invasion in 2003, but after 2008 the state has returned to support some of this policy activities through providing financial loans through the agricultural initiative campaign, with trillions of iraqi dinars without any use, also providing support to some of the agricultural production needs such as fertilizers , tractors and agricultural combines, in addition supporting the pricing policy for the
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