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.
Abstract
The aim of the current research is to prepare an integrated learning program based on mathematics standards for the next generation of the NYS and to investigate its impact on the development of the teaching performance of middle school mathematics teachers and the future thinking skills of their students. To achieve the objectives of the research, the researcher prepared a list of mathematics standards for the next generation, which were derived from a list of standards. He also prepared a list of the teaching competencies required for middle school mathematics teachers in light of the list of standards, as well as clarified the foundations of the training program and its objectives and the mathematical
... Show MoreThis research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri
... Show MoreThe present study aims to explore the effectiveness of a proposed study unit based on the funds of knowledge theory in developing the attitudes towards cultural identity and the proposed study unit. In order to achieve the goal of the study, the two researchers followed the quasi-experimental approach, where the study sample consisted of (28) female students of the fifth-grade at Al-Jeelah Basic Education School, Al-Dakhiliyah Governorate in the Sultanate of Oman. The data were collected by two scales: the first is a scale of attitudes towards cultural identity consisting of (26) items. The second was a scale of attitudes towards the proposed study unit, which consisted of (24) items. The results of the study revealed that the effect of
... Show MoreThe importance of the research lies in preparing exercises using a proposed device to learn the skill of thehuman wheel on a machine rug of ground movements of the artistic gymnastics. As for the research problem:Through the presence of the two researchers as teachers and observers of this sport in the gymnastics hall,they noticed that there is difficulty in the students’ performance of the skill of the round off on the machineof the mat of ground movements, according to the researchers’ opinion, the reason for this is that skillsare taught with the limited availability of assistive devices, as well as the lack of use of these devices inexercises according to biomechanical variables, although they facilitate the learning process
... Show MoreA shocking third species emerged from a family of coronaviruses (CoV) in late 2019 following viruses causing SARS (Severe Acute Respiratory Syndrome-CoV) in 2003 and MERS (Middle East Respiratory Syndrome-CoV) in 2012; it’s a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV). First emerging in China, it has spread rapidly across the globe, giving rise to significant social and economic costs and imposing severe strain on healthcare systems. Since many attempts to control viral spread has been futile, the only old practice of containment including city lockdown and social distancing are working to some extent. Unfortunately, specific antiviral drugs and vaccines remain u
... Show MorePurpose/objective:
1 - To explain the financial impact of the activities and areas of human resources management and the adoption of the methodology for estimating costs on the basis of conduct and statement of how to assess costs and benefits of human resource activities.
2 - Measuring human capital, and its impact on the financial statements.
Design/methodology/approach:
Concentrated dimensions of the research paper's lack of financial statements prepared by the organizations for information mandated human resource its components of the three (attraction - development
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