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.
based search on two variables two main (Administrative empowerment ) and (technical innovation) target detection relationship and influence between the five dimensions (the delegation of authority , personnel training , effective communication, work teams , motivating employees) and
(technical innovation) conducted research in General Company for electrical Industries , and through the sample included the views of managers in the various administrative levels poll .
And adopted a researcher at a major tool for data collection is questionnaire designed to find, as was the contents of the questionnaire analysis according to the Statistical Information System ( Spss), The (55) to identi
... Show MoreThe research aims to identify decent work and its impact in enhancing job immersion. The questionnaire was adopted as a tool to analyze the sample responses of (81) workers to represent an estimated response rate of (88 per cent) out of the total population of (92) individuals. The research adopted descriptive-analytical approach, and reliability calculation, arithmetic means standard deviations, relative importance, and regression analysis adopted on SPSS v.25. The conclusion shows that there is a medium correlation between decent work and job immersion, and there is a low impact of decent work with its dimensions in job immersion; extract the most important acceptable components for job from the sample point of view about the o
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The current research aims to examine the effectiveness of a training program for children with autism and their mothers based on the Picture Exchange Communication System to confront some basic disorders in a sample of children with autism. The study sample was (16) children with autism and their mothers in the different centers in Taif city and Tabuk city. The researcher used the quasi-experimental approach, in which two groups were employed: an experimental group and a control group. Children aged ranged from (6-9) years old. In addition, it was used the following tools: a list of estimation of basic disorders for a child with autism between (6-9) years, and a training program for children with autism
... Show MoreMoney laundering is consider a crime in legal perspective and aphenomenon of negative effects in economic and Social perspective for thevarious countries of the world by the diversity of their economies to make thebadly damaged in the banking service and its reputation in some cases may leadto bankruptcy of banks, and the fact that banks is one of the most importantcircles that revolve the illicit funds, Due to its branched the banking operations,speed and overlap and increase it's complicated with the progress of bankingoperations and the use of electronic services modern here's challenges atvarious levels between the application of the legislation to combat moneylaundering and between actual fact it must find ways and means of legislat
... Show Moreإنّ التّأمّل في الدّراسات الأدبيّة النّقديّة الحديثة الّتي تنظر إلى النّصّ أنّه لوحة تتشكّل من مجموعة تداخلات نصّيّة سابقة للنصّ المُنتج أو مُعاصرة له، تدفع القارئ إلى الغوص في أعماق النّصوص وتحليلها والكشف عن الآليّات والإجراءات الّتي اعتمدت في إنتاجه، وإظهار الجماليّات الفنّيّة التي شكلت في مُجملها كائنا حيّا يُعبّر عن حالات إنسانيّة مُستمرة الحدوث رغم تقادم الأزمان.
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... Show MoreThe influence of culture on accounting systems and practices, including financial reports and accounting information through the values identified by Gray and derived from social-cultural values, and the four accounting values were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values in improving financial performance through attention to the values of accounting culture, this research
... Show MoreThis paper presents a new design of a nonlinear multi-input multi-output PID neural controller of the active brake steering force and the active front steering angle for a 2-DOF vehicle model based on modified Elman recurrent neural. The goal of this work is to achieve the stability and to improve the vehicle dynamic’s performance through achieving the desired yaw rate and reducing the lateral velocity of the vehicle in a minimum time period for preventing the vehicle from slipping out the road curvature by using two active control actions: the front steering angle and the brake steering force. Bacterial forging optimization algorithm is used to adjust the parameters weights of the proposed controller. Simulation resul
... Show MoreMost studies indicated that the values of atmospheric variables have changed from their general rates due to pollution or global warming etc. Hence, the research indicates the changes of direct solar radiation values over a whole century i.e. from 1900 to 2000 depending on registered data for four cities, namely (Mosul - Baghdad - Rutba - Basra. Moreover, attemptsto correlate the direct solar radiation with the temperature values have been recorded over that period. The results showed that there is a decreasing pattern of radiation quantities over time throughout the study period, where the value of direct radiation over the city of Baghdad 5550 w/m2 was recorded in the year 1900, but this ratio decreased cle
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