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.
Each organization has values and objectives, tangible and intangible properties of its products. The reflection of properties on the brand constitutes the identity of the brand that contributes to building the customer's convictions about the products or services provided by any organization and its brand in a positive or negative way. This is reflected in purchasing behavior, which may push forward the progress towards marketing goals or deviation from them. Therefore, the current research came to identify the brand identity, its types and the factors affecting them and how they affect to achieve each of the marketing goals. At a time when
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The current research variables have received increasing attention in the recent period because they are one of the important issues affecting the future of organizations, as a result of the speed of environmental variables that have greatly affected organizations and for the purpose of explaining the relationships and links between research variables, as this research presents a test "the type and direction of the relationship between strategic foresight capabilities As an independent variable and green creativity "as a respondent variable. A set of questions has arisen about the basic research problem, including what is the nature and level of interest in the research variables (strategic foresight capabilities an
... Show MoreMangrove landscaping in the Segara Anakan Lagoon (SAL) is an adaptation pattern of mangrove ecosystems to live and grow in unstable areas. This research aimed to develop a mangrove landscape to mitigate the impacts of ocean waves, currents, and inundation due to climate change. The study was conducted in SAL and Cilacap Coast (CC) using the environmental properties and climate change data. The data obtained were analyzed using mapping and trendline analyses. The results showed that mangrove landscaping in Segara Anakan had four zones with Nypa frutican, Rhizophora styllosa, Aegiceras corniculatum, Rhizophora apiculata, Avicennia marina, Sonneratia alba identified as the best adaptation of mangrove species. Climate change give a high impa
... Show MoreIn addition to the primary treatment, biological treatment is used to reduce inorganic and organic components in the wastewater. The separation of biomass from treated wastewater is usually important to meet the effluent disposal requirements, so the MBBR system has been one of the most important modern technologies that use plastic tankers to transport biomass with wastewater, which works in pure biofilm, at low concentrations of suspended solids. However, biological treatment has been developed using the active sludge mixing process with MBBR. Turbo4bio was established as a sustainable and cost-effective solution for wastewater treatment plants in the early 1990s and ran on minimal sludge, and is easy to maintain. This
... Show MoreThe study aims to build a proposed training program for school leaders in the Sultanate of Oman on the planning practices of the Kaufman model in light of the needs and challenges of reality. It also aims to identify the challenges facing school leaders in practicing the stages of strategic planning. To achieve these objectives, the study adopted the descriptive approach due to its suitability to the nature of the study. A questionnaire was used to collect the needed data. The study sample included (225) individuals from school principals, their assistants and senior teachers in post-basic education in the Sultanate of Oman. After processing the data statistically, the study concluded that the reality of planning practices for school lea
... Show MoreThe media, especially the satellite channels in our time, are one of the most important pillars of daily life, public and private, for society and people, and are considered by sociologists and sociologists as one of the most important factors of social upbringing and the most important, as a result of the technological and technological development of the media as well as increasing their numbers and vertical and horizontal expansion locally, As well as entering into the lives of individuals and people and leading them to important sites within their interests and preferences, not to mention the long time spent exposure to those media and benefit from the programs offered or broadcast. , The problem of this research is that there is a l
... Show MoreThe current study aims to investigate the effect of strategic knowledge management practices on an excellent performance at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII). The present research is designed according to the descriptive method. To achieve the mentioned research objective, the researchers used the questionnaire as the main data collection tool. The research sample was 150 managers who are working at the top and middle management levels. To analyses the data gathered and reaching the results, several statistical techniques were used within AMOS.V25, SPSS.V21Software, This study reached a set of results, the most important of which is the existence of a positive correlat
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The subject ( meaning of added verbs) is one of the main subjects
which study in morphology since in Arabic language. It is include the meaning
of each format, and the increased meaning occurred by this increment in the
verbs.
The (strain) is one of very important meaning in this subject, it takes a
wide area of morphology studies, and interesting of scientists and
researchists.
There are two famous formats for this meaning; (infa la انفع
ل ), and (ifta
la افتع
ل ). Also There are another formats for the same meaning, but less than
the first two in use, they are; (taf ala تفعّ
ل ), (tafa ala تفاع
ل ), (taf lala ) ,(تفعل
ل
ifanlala افعنلل ), (ifanla .(
As cultures are mainly divided into collectivistic and individualistic, members tend to emphasize, through communication, either their position as part of their group or their independence from the group. This emphasis is manifested in using the pragmatic concepts of positive politeness and negative politeness. The present study looks into the reflection of these two cultures in Rockstar’s renowned video game, Red Dead Redemption 2 (2018). It aims at identifying the two cultures as present in the game and showing their significance to its narrative. It fills the gap in the studies of language used within video games as well as its cultural reflections. The study addresses the following question: What are the positive and negative
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