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.
Several million tons of solid waste are produced each year as a result of construction and demolition activities around the world, and brick waste is one of the most widely wastes. Recently, there has been growing number in studies that conducted on using of recycling brick waste (RBW) to produce environmentally friendly concrete. The use of brick waste (BW) as potential partial cement or aggregate replacement materials is summarized in this review where the performance is discussed in the form of the mechanical strength and properties that related to durability of concrete. It was found that, because the pozzolanic activity of clay brick powder, it can be utilized as substitute for cement in replacement level up t
... Show MoreSeveral million tons of solid waste are produced each year as a result of construction and demolition activities around the world, and brick waste is one of the most widely wastes. Recently, there has been growing number in studies that conducted on using of recycling brick waste (RBW) to produce environmentally friendly concrete. The use of brick waste (BW) as potential partial cement or aggregate replacement materials is summarized in this review where the performance is discussed in the form of the mechanical strength and properties that related to durability of concrete. It was found that, because the pozzolanic activity of clay brick powder, it can be utilized as substitute for cement in replacement level up to 10%. Whereas,
... Show MoreIt is widely accepted that early diagnosis of Alzheimer's disease (AD) makes it possible for patients to gain access to appropriate health care services and would facilitate the development of new therapies. AD starts many years before its clinical manifestations and a biomarker that provides a measure of changes in the brain in this period would be useful for early diagnosis of AD. Given the rapid increase in the number of older people suffering from AD, there is a need for an accurate, low-cost and easy to use biomarkers that could be used to detect AD in its early stages. Potentially, the electroencephalogram (EEG) can play a vital role in this but at present, no reliable EEG biomarker exists for early diagnosis of AD. The gradual s
... Show MoreThis study was conducted on a sample of commercial banks in Iraq, chosen according number of considerations for twenty banks, contained two public banks and eighteen private banks. &
... Show MoreThe deficiency in the nurse staff in the health organizations consider an important problem that must be studied and solved basically , not only because it affect on the health organization and it's strategic goals , but also it affect the human being and it's health which can't be substituted with anything or delayed in it's treatment ,This research aims to necessary for health organizations to strategically help in maintaining the nurse staff and to keep that in it's strategic orientation and it's mission , moreover , the health organizations must study the reality of the nurse in the health organizations and know the causes beyond leaving the nurse staff the nurse job , and then remove
... Show MoreSewer system plays an indispensable task in urban cities by protecting public health and the environment. The operation, maintenance, and rehabilitation of this network have to be in a sustainable and scientific manner. For this purpose, it is important to support operators, decision makers and municipalities with performance evaluation procedure that is based on operational factors. In this paper, serviceability and performance indicator (PI) principles are employed to propose methodology comprising two enhanced PI curves that can be used to evaluate the individual sewers depending on operational factors such as flowing velocity and wastewater level in the sewers. In order to test this methodology; a case study of al-Ru
... Show MoreGovernment-sponsored projects in Iraq significantly improve the economic situation and provide services but face high rates of troubling blocks. This work aims to identify indicative factors of the Troubled Project using periodic health check reports based on a literature review and interviews with Iraqi experts. As a result, a questionnaire was prepared that included four sections. The first is personal information; the second section is information about knowing the level of institutions’ implementation of project management through prepared documents. The third section is about indicative factors for the project's trouble, including 25 workers; the fourth section is about the questions in the periodic reports to che
... Show MoreTransit agencies constantly need information about system operations and passengers to support their regular scheduling and operation planning processes. The lack of these processes and cultural motivations to use public transportations contributes enormously to the reliance on the private cars rather than public transportation, resulting in traffic congestions. The traffic congestions occur mainly during peak hours and the accidents happening as a result of road accidents and construction works. This study investigates the effects of weekday and weekend travel variability on peak hours of the passenger flow distribution on bus lines, which can effectively reflect the degree of traffic congestion. A study of passen
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In this work, the plasma parameters (electron temperature (Te), electron density( ne), plasma frequency (fp) and Debye length (λD)) have been studied by using the spectrometer that collect the spectrum of Laser produce CdTe(X):S(1-X) plasma at X=0.5 with different energies. The results of electron temperature for CdTe range 0.758-0.768 eV also the electron density 3.648 1018 – 4.560 1018 cm-3 have been measured under vacuum reaching 2.5 10-2 mbar .Optical properties of CdTe:S were determined through the optical transmission method using ultraviolet visible spectrophotometer within the r
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