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.
Luqman's story stated that human instinct, if I was brought up properly, reaches wisdom and inflicts the right to everything. It is to go to worship God and adhere to the satisfaction of morals and high morals that are ordered to meet among human beings in this life, because this worship educates in the soul the most beautiful morals needed by human beings of honesty, honesty and modesty, and the work of good and virtues, and distancing the soul from evil and vices.
The military presence in the Gulf region after the British withdrawal from it in 1971 was one of the most important pillars of the American strategy to climb the ladder of global leadership, as the geostrategic features that the region enjoyed provided factors of controlling energy sources and global trade routes. The United States of America guarantees Western Europe and Japan the process of access to energy sources and the exclusion of its opponents from the region, especially the Soviet Union, and the growing American military presence in the Gulf after the invasion of Iraq in 2003. On the other hand, the region experiences many contradictions, some of which threaten its security, such as the exacerbation of disputes between its count
... Show MoreDuring the period 1970-2006 the Marshes-land region was exposed to several change into many sides of vanishing steeling and growth as follow :
1- Drying this region after 1991,and re-flooded again during 2003. Many other large Marsh-land, like al-Hawaisa was dried by cutting off inlet-water fed from Iran sources .As asqunance there are transferred to different kinds of swamps ,followed by major change in the structure of the region as the rural settlement concerned. Rural settlement in this area starts new push of migration. The research did not take that in consideration in this thesis because some others took it in details in some thesis and researches. The situation of Marsh-land is getting anew face after those major changes which
الاحداث السياسية في العراق بعد 2003 وأثر الانتماء والوعي في التشكيل العراقي المعاصر
The study included isolation and diagnosis of fungi that infect Foeniculum vulgare Mill planted in the Department of Drugs and Medicinal Plants, Pharmacy College - University of Baghdad, different symptoms such as wilting and yellowing, stunting on the plants were observed fungi: Alternaria alternata, Rhizoctonia solani, Phoma herbarum and Fusarium oxysporum, The disease incidence ranging between 5-10%. Studied the effect of Foeniculum vulgare plant seeds extract against Alternaria alternata, Rhizoctonia solani, Phoma herbarum and Fusarium oxysporum,where tested the concentrations 0,2.5 and 5% of alcoholic extract of fennel seeds showed ef
... Show MoreOryza sativa japonica (ofada rice) is largely grown in Aramoko, Abakaliki and Ofada are communities and consumed by both the poor and rich in Nigeria. A total of twenty ofada rice farmlands were identified in each study area and rice samples were randomly collected, thoroughly mixed to make a representative sample from each farmland. Soil samples were collected in each farm to a depth of 5-15cm from at least eight different points and thoroughly mixed together to form a representative sample. The samples were thereafter taken to the laboratory for preparation and spectroscopic analysis. A well-calibrated NaI(Tl) gamma-ray detector was used in spectrometric analysis of the samples and descriptive statistics was used to analyze th
... Show MoreThis research aims to explore the impact of strategic intelligence by his dimensions (Foresight , system thinking, vision, motivation and partnership) on decision making styles which represented by ( rational, intuitive, dependent, Spontaneous and Avoidant style) for a sample of the administrative leaders in the center of Reconstruction &Housing Ministry and Some its formations which are companies of (Sa'ad, Al Mansour, al Farouq, Assyria, al-Mu'tasim, al- Rasheed, and Public Authority for Housing). So to achieve the research objectives and to test hypotheses, it has been relying
... Show MoreThis study reports testing results of the transient response of T-shape concrete deep beams with large openings due to impact loading. Seven concrete deep beams with openings including two ordinary reinforced, four partially prestressed, and one solid ordinary reinforced as a reference beam were fabricated and tested. The effects of prestressing strand position and the intensity of the impact force were investigated. Two values for the opening’s depth relative to the beam cross-section dimensions were inspected under the effect of an impacting mass repeatedly dropped from different heights. The study revealed that the beam’s transient deflection was increased by about 50% with gre
Abstract
The research aims to determine the nature of the Iraqi market in terms of banking financial stability and the extent impact of the operational efficiency on it, Accordingly, chosen 15 relational banks were chosen as an intentional sample that could represent the Iraqi banking system for the period 2010-2020. The operational efficiency variable was measured according to the data envelope model, and banking financial stability used CAMELS model which includes five indicators (capital adequacy, asset quality, management quality, profitability, and liquidity), so for testing the research hypotheses used the random regression model by adopting the S
... Show MoreCentric study on the interest of the Directorate General of Training and Development / Ministry of Electricity to consolidate the concept of process and enhancement of knowledge in the areas of organizational change، it reached a sample of the study (44) people who are highly heads of departments، technicians and administrators in different sections of the Directorate and by using the correlation coefficient (Spearman) & coefficient of simple regression been tested correlations between variables and the impact of the study، as has been reached to integrate the role of cognitive processes with the areas of organizational change and relationships that were significant at the level of overall dimensions and subsidiary organs.
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