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 aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in
... Show Morepaid recent developments in the information and communications technology and the accompanying developments in the global market to pay particular accounting information users to demand more sophistication in terms of corporate financial reporting systems, which led to the emergence of a new type of reporting (financial reporting in real time). where is the information and communications technology mainstay Nations for the development and progress, thanks to the development of technology that have made the transmission of information easily conducted and high speed to all who need it, communication is instantaneous and the flow of information via the internet dramatically exceeded the border temporal and spatial anywhere in the w
... Show MoreThe technology in continuous and quick development, that reflects in all parts of our life and interred both scientific and practical fields. Marketing is one of them, a customer’s way to deal with choosing and demanding the product deferent from the traditional way. Some of the buying processes are electronic now, therefore the current research is identifying the digital channels that entered the world of marketing and influenced the activities and types that fall under this name and how it affects in positioning strategy, which is how to install the product or brand in the mind of the customer and was dimensions (brand identity, brand personality, brand communication, brand awareness, brand image), The researcher took t
... Show MoreThis research means a study (the impact of the Arab-Islamic environment on contemporary painting, the artist Abd al-Rahman al-Suleiman as a model). The research falls into two axes: the first: the theoretical axis, and the second: the applied axis. The first axis dealt with an introduction that contained: (the research problem, its importance, its goal, its limits, and the definition of terms). This research aims to uncover (the impact of the Arab-Islamic environment on contemporary painting, and the artist Suleiman was a model). And the research limits spatially: Saudi Arabia, and temporally: 2010-2014. This theme included two topics: The first: the characteristics of the Saudi environment and its impact on art. The second: the s
... Show MoreBackground: Dental caries is generally given the highest priority in national oral health services for adult populations. Yet, there is no study which has explored the impact on quality of life specifically related to dental caries in samples of dental students. The purpose of the current study was to assess the impact of caries experience on quality of life among dental students in three governorates in Iraq. Materials and Methods: This observational study included 1364 dental students aged 18–22 years old, from three governorates. Information on quality of life was obtained from a structured, self-administered questionnaire from the students who were willing to participate in the study. The data was collected, summarized and sta
... Show MoreAbstract:
There is a close relationship between rigidity and distort structure of production and productivity and inflation rates. The effects of this relationship are distorted the contribution rate of the productive sectors and the disproportionate of exchange rate in foreign trade.
raising the general level of prices is one of the way that have been used by previous governments (inflationary financing or deficit financing) in order to speed up the process of capital formation, depending on the availability of economic resources idle.
The fabricating inflation for development does not represent a true understanding of the nature of the
... Show MoreBackground: Dysfunction of sinoatrial node is a set of abnormal rhythms which are resulted from the sinoatrial node malfunction of the sinus node, the chief natural cardiac pacemaker. The common, and occasionally, the single method for treatment of heart arrhythmias was implantation of pacemaker, which reduce symptoms exactly occurs after implantation. Aim: To detect the role of smoking on cardiac electrophysiology parameters in sinus node dysfunction in Iraqi patients such as SNRT and AH. Methods: A cross sectional study, was conducted on 59 patient ranging between 20-50 years old and involving 35 female and 24 male patients, suffering from an unexplained symptoms of sinoatrial node dysfunction (SND). The enrolled participants were gathere
... Show MoreCopper tin sulfide (Cu2SnS3) thin films have been grown on glass
substrate with different thicknesses (500, 750 and 1000) nm by flash
thermal evaporation method after prepare its alloy from their
elements with high purity. The as-deposited films were annealed at
473 K for 1h. Compositional analysis was done using Energy
dispersive spectroscopy (EDS). The microstructure of CTS powder
examined by SEM and found that the large crystal grains are shown
clearly in images. XRD investigation revealed that the alloy was
polycrystalline nature and has cubic structure with preferred
orientation along (111) plane, while as deposited films of different
thickness have amorphous structure and converted to polycrystalline
Cloud computing is the new technological trend for future generations. It represents a new way to use IT resources more efficiently. Cloud computing is one of the most technological models for developing and exploiting infrastructure resources in the world. Under the cloud, the user no longer needs to look for major financing to purchase infrastructure equipment as companies, especially small and medium-sized ones, can get the equipment as a service, rather than buying it as a product. The idea of cloud computing dates back to the sixties of the last century, but this idea did not come into actual application until the beginning of the third millennium, at the hands of technology companies such as Apple, Hp, IBM, which had
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