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.
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, Muhammad and his family
The good and pure and after his companions
God Almighty said: ( ) Do they not contemplate the Qur’an? If it had been from other than God, they would have found in it much discrepancy. God Almighty has made the well-being of people and their lives linked to faith in it. So what is the need of people today to return to the Book of their Lord so that they may return to the right path that God intended for His servants so that they may attain sustenance? Security and the good life. How could it not be, when many of the nations of the world no longer see security or stability because their leaders and politic
... Show MoreThis study reveals the impact of critical reading on viewers understanding and astatic judgment at artworks. And aims to find out the reasons and motives behind their issuing of these judgments towards artworks.
The study adopts the qualitative method as two pre and post interviews were conducted and analysed according to a thematic analysis method.
The results show that critical reading contributes to their understanding of the content of artworks and the message that the artist would like to convey to the recipient audience. and directs them towards the aesthetic judgment that is based on full understanding of the philosophical contents of the artwork, which, in turn, contributes to the development of artistic culture and a
Background: The emergence of vaping as a popular alternative to traditional smoking has raised concerns regarding its potential impact on oral health. specifically affects the oral health of dental students, who are not only consumers of these products but also future practitioners tasked with educating patients on oral hygiene and health risks. purpose: This study investigated the dental and oral health impact of VAPE among male dental students. Methods: A self-administered questionnaire comprising 20 questions was meticulously designed to gather relevant data about their VAPE use and its implications on dental and oral health. Results: 43% of participants reported using VAPE, predominantly employing salt nicotine (48.8%) over free
... Show MoreThe research included four chapters starting with the chapter dealing with the problem of child abuse which was one of the most important educational and social problems faced by children from their parents or family members. The most common forms of abuse are physical and psychological violence. The problem of school delays is also one of the most important educational and psychological issues that concern educators, which occur because of violence and neglect of the family. The study pointed out that domestic violence is one of the issues that has started to alarm both the global and local communities, because childhood is one of the most important stages of the human development system, which is healthy in terms of physical, mental, p
... Show MoreThe research aims to study strategic training and its impact on improving the performance of the inspectors general offices in Iraqi ministries, through two variables strategic training Which include Four Dimensions ( Strategic analysis , Formulation of Training Strategy , Implement the Training Strategy , Evaluation ) and Performance included Three dimensions ( Efficiency , Effectiveness , Added-Value).
This research problem is that the Offices of Inspectors rely on pre-made training Programs received from training centers without designing the training programs that provide the employees with the skills and abilities that lead to the implementation of the current and future goals of the orga
... Show MoreIn accounting studies, more than one method is used to measure income and balance sheets elements. One of these methods is called the fair value, which use to determine the assets and liabilities ad it includes the benefits or self-satisfaction ability. This paper aims to focus on the importance of fair value as a basis of accounting measurement and its effects to achieve the relevant characteristics by using the equation is used by (Kythreotis) in his research, And Also , Editing this equation depending on the financial data and information of Iraqi Banks as a case.
The research aims to know the concept of politic behavior as one of the important behaviours in the different fields and sectors. It is considered to be part of the organizatial work to face the expected risks. It includes two group of factors personal (self –monitors, locus of control ,expectation s of success, perceived job alternatives)and organizational(promotion ,division resources,role ambiguity ,democratic decision)studied by the researcher in the frame of the relationship with the variable of display continuous trust matain which includes two variable (build trust mantain, display trust continuouness)through applied frame by random sample consists of (90)employee at Farouq State
... Show MoreThe current work aims to evaluate the association between genetic mutations in thymidylate synthetase (
The research aims to investigate the possibility of joint auditing in improving the market value of Iraqi companies listed on the Iraq Stock Exchange. The sample was represented by 10 Iraqi companies listed in the Iraq market for the period from 2014-2017 (2 years before implementation and 2 years after implementation) and the research was based on the idea that joint auditing enhances investor confidence and raises their level of security as a result of providing quality and reliable reports, and thus This indicates good news in the market that reflects on the performance of stocks and the market value of companies that adopt joint auditing. The results of the analysis indicate an improvement in the market value, but this improv
... Show MoreBackground: One of the most prevalent procedures in oral surgery is the removal of impacted mandibular third molars, typically accompanied by trismus, edema, and pain. Several methods and biomaterials were implemented to mitigate or avoid these surgical problems. Objectives: To evaluate the efficiency of chlorhexidine gel (WISDOM®) in minimizing postoperative sequelae associated with the impacted mandibular third molar that will be surgically extracted and its role in promoting early soft tissue closure of the surgical site. Methods: The study design was a double-masked and randomized, controlled clinical study that included healthy patients needing the removal of a mandibular third molar through surgery. The participants were rand
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