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.
Evidences indicate that human beings were preoccupied with extreme forms of mental and psychic experiences long before they were recorded in literature. Greek myths and legends appear to include symbolizations of delusions, mania, and other bizarre forms of thought and behaviuor. The figure of the mad man or woman is analogous to the wild man, or the imaginary being who appears in various forms throughout western literature and art. Various studies refer to the notion of the wild man as a response to a persistent psychological urge. This urge gives an external expression and a valid form to the impulses of reckless physical self-assertion which is believed to be hidden in all of us, but is normally kept under control. Such impulses were exp
... Show MoreObjective : Multiple sclerosis (MS) is a common neurological disease deeply linked with the immune-inflammatory disorders whereas the term (multiple) mostly refers to the multi-focal zones of Inflammation caused by lymphocytes and macrophages infiltration besides oligodendrocytes death. Accordingly , the dysfunctional immune system able to damage myelin ( a pivotal component of the central nervous system ) which responsible for communication among neurons. The aim of the present study is to innovate a biochemical relationship between MS and thyroid hormones (THs) by highlighting immunological responses and also to examine the action of Interferon beta (IFNβ) drug on thyroid hormone (THs) and thyroid stimulation hormone (TSH). Materials and
... Show MoreTakbiratul Ehram "The First Takbeer to Start Prayer" means: the words that the worshiper says to start his prayers, and refrain from anything invalidates it. the findings revealed that the four school jurists agreed that the prayer is not valid without Takbiratul Ehram "The First Takbeer to Start Prayer", and they disagreed on its description, so the majority of jurists said that it is a pillar, and some of them called it an obligatory, but Hanafi made it a condition. Likewise, the four jurists agreed that the one who articulates Takbiratul Ehram "The First Takbeer to Start Prayer" with the word: “Allahu Akbar,”; his Takbeer is correct, and they disagreed about the one who adds a word, or replaced it with another, where the m
... Show MoreThe bandwidth requirements of telecommunication network users increased rapidly during the last decades. Optical access technologies must provide the bandwidth demand for each user. The passive optical access networks (PONs) support a maximum data rate of 100 Gbps by using the Orthogonal Frequency Division Multiplexing (OFDM) technique in the optical access network. In this paper, the optical broadband access networks with many techniques from Time Division Multiplexing Passive Optical Networks (TDM PON) to Orthogonal Frequency Division Multiplex Passive Optical Networks (OFDM PON) are presented. The architectures, advantages, disadvantages, and main parameters of these optical access networks are discussed and reported which have many ad
... Show MoreKetoprofen has recently been proven to offer therapeutic potential in preventing cancers such as colorectal and lung tumors, as well as in treating neurological illnesses. The goal of this review is to show the methods that have been used for determining ketoprofen in pharmaceutical formulations. Precision product quality control is crucial to confirm the composition of the drugs in pharmaceutical use. Several analytical techniques, including chromatographic and spectroscopic methods, have been used for determining ketoprofen in different sample forms such as a tablet, capsule, ampoule, gel, and human plasma. The limit of detection of ketoprofen was 0.1 ng/ ml using liquid chromatography with tandem mass spectrometry, while it was 0
... Show MoreA collection of 118 specimens of Iraqi phasianid birds belong to four species was examined
for haematozoa. Results show that 21.2% of them were infected with one or more of four
species of blood parasites; Haemoproteus danilewskyi, H. santosdiasi, Plasmodium sp. and
microfilaria. Haemoproteus danilewskyi is reported here for the first time in Iraq.