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 paper presents a computer simulation model of a thermally activated roof (TAR) to cool a room using cool water from a wet cooling tower. Modeling was achieved using a simplified 1-D resistance-capacitance thermal network (RC model) for an infinite slab. Heat transfer from the cooling pipe network was treated as 2-D heat flow. Only a limited number of nodes were required to obtain reliable results. The use of 6th order RC-thermal model produced a set of ordinary differential equations that were solved using MATLAB - R2012a. The computer program was written to cover all possible initial conditions, material properties, TAR system geometry and hourly solar radiation. The cool water supply was considered time
... Show MoreDBN Rashid, Journal of Education College Wasit University 1(1):412-423, 2007
The study of properties of space of entire functions of several complex variables was initiated by Kamthan [4] using the topological properties of the space. We have introduced in this paper the sub-space of space of entire functions of several complex variables which is studied by Kamthan.
The main object of this paper is to study the representations of monomial groups and characters technique for representations of monomial groups. We refer to monomial groups by M-groups. Moreover we investigate the relation of monomial groups and solvable groups. Many applications have been given the symbol G e.g. group of order 297 is an M-group and solvable. For any group G, the factor group G/G? (G? is the derived subgroup of G) is an M-group in particular if G = Sn, SL(4,R).
It is believed that culture plays an important role in the ELF classroom activities (Al- Mutawa, & Kilani, 1989:87). It is important for the teacher to recognize potential negative (culturally based) perceptions of their learners. In Iraq, for instance, it is not. Uncommon to meet silent expressionless students that arc supposedly English language learners. It is possible for the beginner to interpret this negatively as a lack of interest in the study of English. This interpretation may play a harmful role in the classroom methodology. An instructor has to be intercultural competent to be an effective teacher. It will be more effective if the instructor adopts a consistent style of instruction to allow learners to adapt within the bounds of
... Show MoreBrachycerous Dipteran species on alfalfa plant Medicago sativa surveyed in several regions of Iraq from March to November 2012. The study was registered 14 species belonging to nine genera and four families. The results showed that Limnophra quaterna, Atherigona laevigata and Atherigona theodori as new records to Iraq and new pests of alfalfa.