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.
In The Name of Allah Most Gracious Most Merciful
This is a study dedicated to explaining the conditions of the end of heaven, stage by stage; And to draw the final picture of it, through the facts of the Qur’an, and to make the contextual integration of the verses of the end of heaven, and their arrangement in an intentional arrangement, a path that guides us to knowing the integrated picture of it on the Day of Resurrection, according to scientific interpretation.
The importance and usefulness of the research lies in:
Extracting the order of the stages of the end of heaven, from its first state to its last, which came in separate verses of the Qur’an, each one of which was placed in a surah that was consistent w
... Show MoreBackground: Sonographic examination is an important tool in assessment of normal and abnormal cervical lymph nodes. The aim of the study is to assess the distribution and the characteristic features of normal cervical lymph nodes in a sample of Syrian population. Materials and Methods: Fifty healthy Syrian subjects (25 men and 25 women) with an age of 20 -60years old, who had their cervical lymph nodes examined by ultrasound. Three hundred and two lymph nodes were detected. Lymph nodes were evaluated for their number, size, site, echogenic hilus, shape, as well as for the border sharpness. The subjects were categorized by age into four groups, (20 -30, 31 - 40 , 41 - 50 , 51- 60 years ). Statistical analysis of data was done using SP
... Show MoreThe present study attempts to shed light on some biological aspects and characteristics of Piaractus brachypomus, including some biometrics, phenotypic and feeding pattern that characterizes this species. Besides, the study touches upon the body shape and the Otolith. These fish species have recently been seen frozen in the Iraqi local market. The standard length of fish specimens in this study reach 26.55cm it exceeded the specimens of Pacu fish collected from other studies from other countries, As well the specimens weight was 632gm it exceeded other studies mentioned in this manuscript. As the irregularity in the distribution of teeth rows, especially in the lower jaw was clear in our specimens. The average weight of some skull b
... Show MoreA Modified version of the Generlized standard addition method ( GSAM) was developed. This modified version was used for the quantitative determination of arginine (Arg) and glycine ( Gly) in arginine acetyl salicylate – glycine complex . According to this method two linear equations were solved to obtain the amounts of (Arg) and (Gly). The first equation was obtained by spectrophotometic measurement of the total absorbance of (Arg) and (Gly) colored complex with ninhydrin . The second equation was obtained by measuring the total acid consumed by total amino groups of (Arg) and ( Gly). The titration was carried out in non- aqueous media using perchloric acid in glacial acetic acid as a titrant. The developed metho
... Show MoreHCl is separated from HCl –H2SO4 solution by membrane distillation process(MD). The flat –sheet membranes made from polyvinylidene fluoride (PVDF) and polypropylene (pp.). Plate and frame these types of membrane where used in the process. The feed is a mixture of HCl and H2SO4 acids compositions depended on metals treated object.HCl concentration increased in the permeate during the process but sulfuric acid increased gradually in the feed .During the concentration of solution acids concentrations in the feed at the beginning were 50 g/dm3 of sulfuric acid and 50 g/dm3 of hydrochloric acid at 333K feed temperature the permeate flux was 71 dm
... Show MoreThe injection of Low Salinity Water (LSWI) as an Enhanced Oil Recovery (EOR) method has recently attracted a lot of attention. Extensive research has been conducted to investigate and identify the positive effects of LSWI on oil recovery. In order to demonstrate the impact of introducing low salinity water into a reservoir, simulations on the ECLIPSE 100 simulator are being done in this work. To simulate an actual reservoir, an easy static model was made. In order to replicate the effects of injecting low salinity water and normal salinity, or seawater, the reservoir is three-phase with oil, gas, and water. It has one injector and one producer. Five cases were suggested to investigate the effect of low salinity water injection with differen
... Show MoreThe main objective of this research is to find the coefficient of permeability (k) of the soil and especially clayey soil by finding the degree of consolidation (rate of consolidation). New modify procedure is proposed by using the odometer (consolidation) device. The ordinary conventional permeability test usually takes a long time by preparing and by testing and this could cause some problems especially if there is a need to do a large number of this test and there were a limited number of technicians and/or apparatus. From this point of view the importance of this research is clear, since the modified procedure will require a time of 25 minute only. Derivation made to produce an equation which could be used to fined the permeabi
... Show MoreAbstract
The pressures of life have become a tangible phenomenon in all societies in varying degrees. This disparity determines several factors, including the nature of societies, the level of their urbanization, the intensity of interaction, the intensity of conflict, and the increasing rate of change in those societies. many people name The modern era in which we live the “era of pressures", where one of the most important of these changes is the “new Coronavirus 19-COVID”, which has spread widely throughout the world, as the pandemic, has affected all aspects of daily life, including the educational and academic process, academic activities have been suspended in universities, which caused sudden change
... Show MoreMicrofinance Institutions (MFIs) offers small loans with easy repayment system and till now these institutions have served millions of needy people around the globe. This study highlights the hurdles influence the smooth working and growth of Microfinance institution in Egypt. The structured interviews were conducted from the top and mid-level managers of MFI's. This study revealed that interest rate, political and economic conditions, corruption, customer outreach, competition and technology are the important elements for MFI's success. It is evident that lack of use of technology and less importance drawn on customer outreach programs are the main challenges of MFI's in Egypt. This study provides a roadmap for practitioners and strategic
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