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.
The experiment was carried out to study the effect of NPK and Inicium using two concentration for each of them 1 and 2 gm/L for NPK and 5 and 10 ml/L for Inicium on some physiological characters of Lycopersicon esculentum and mitotic division index of seedling radical apex. The results showed that all the characters increased plant height, stem diameter, leaves number, length of leaf, lobs number in one leaf, length of root and root diameter. The data showed that the percentage of cell division, mitotic division and Telophase stage increased in seedling radical apex comparison with control plants.
Fundamentalist detective
On matters of consensus
Of Khala book complete the teacher benefits of Muslim
Judge Ayaz
(May God have mercy on him)
Strategy Descrtibes How an Organization Matches its own Capabilites With Opportunities in Environment , in Order to Accomplish its Overall Objectives , So That The Organization is Considering Responding to Challenges by Adopting one or More of Strategies, Like Differentioning its Product, or Achieving Cost Leadership.
The Key Role of Management Accountant is to Evlaute The Successful it Has Been in Implementing Organization Strategy.
This Research Target to Explain The Key Role of Management Accountant in Evaluate of Organization Strategy. by Strategic Analysis of Operating Income From Specific Sources Such as Cost Savings and Growth in Stead of Emphasizing Only The Aggrega
... Show MoreIn this study, the effect of intersecting ribs with inclined ribs on the heat transfer and flow characteristics of a high aspect ratio duct has been numerically investigated. The Relative roughness pitch (P/e) is 10 and the Reynolds number range from 35,700 to 72,800. ANSYS (Fluent-Workbench 18.0) software has been utilized to solve the Reynolds averaged Navier-Stokes (RANS) equations with the Standard k-ε turbulence model. Three ribbed models have been used in this study. Model 1 which is a just inclined ribs, Model 2 which has a single longitudinal rib at the center with inclined ribs and Model 3 which has two longitudinal ribs at the sides. The results showed that the heat transfer rate has been enhanced when the int
... Show MoreThe research aims to recognize the impact of the training program based on integrating future thinking skills and classroom interaction patterns for mathematics teachers and providing their students with creative solution skills. To achieve the goal of the research, the following hypothesis was formulated: There is no statistically significant difference at the level (0.05) between the mean scores of students of mathematics teachers whose teachers trained according to the proposed training program (the experimental group) and whose teachers were not trained according to the proposed training program (the control group) in Pre-post creative solution skills test. Research sample is consisted of (31) teachers and schools were distribut
... Show MoreAcquisition provisions in Islamic jurisprudence
This paper investigates the concept (α, β) derivation on semiring and extend a few results of this map on prime semiring. We establish the commutativity of prime semiring and investigate when (α, β) derivation becomes zero.
In this work, silver (Ag) self-metallization on a polyimide (PI) film was prepared through autocatalytic plating. PI films were prepared through the solution casting method, followed by etching with potassium hydroxide (KOH) solution, sensitization with tin chloride (SnCl2), and the use of palladium chloride (PdCl2) to activate the surface of PI. Energy-dispersive X-ray analysis (EDX) showed the highest peak in the (Ag) region and confirmed the presence of AgNPs. The diffraction peaks at 2θ = 38.2°, 44.5°, 64.6°, and 78.2° represented the 111, 200, 220, and 311 planes of Ag, respectively. The FT–IR an
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