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 research aims to demonstrate the impact of tax techniques on the quality of services provided to income taxpayers by studying the correlational and influencing relationships between the exploited variable (tax techniques) and the dependent variable (the quality of services provided to income taxpayers), and in line with the research objectives, the main hypothesis of the research was formulated (there is a relationship Significance between tax techniques and the quality of services provided to income taxpayers) a number of sub-hypotheses emerged from this hypothesis that were stated in the research methodology, and a number of conclusions were reached, the most important of which were (through the use of the correlation coeff
... Show MoreRecently, environmental noise has arisen from various sources, such as those from exhaust mufflers of combustion engines found in cars, trucks, or power generators, which produce significant noise during their operation. Controlling the radiated noise from these mufflers is a major factor in improving acoustic comfort and minimizing the impact on the surrounding communities. Numerous research has been presented for this reason by modification of the internal structure of the exhaust muffler. The main objective of this work is to reduce the noise level emitted from exhaust mufflers. This can be achieved by adjusting structure parameters to attenuate the surrounding environment's radiated noise. Analysis of pressure-wave propagation h
... Show MoreThe research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of
... Show MoreThe political system in Indonesia, since gaining independence from the Dutch colonialism on the seventeenth of August 1945, has gone through long stages. The Indonesian constitution stipulated that the country is based on a democracy. In 1956 the first free elections were held in Indonesia, and President Sukarno announced the adoption of the directed democratic system Then, during the era of President Suharto, the state entered a phase called democracy based on the Five Pancasila principles, which is a false democracy because it served the interests of Suharto, who in his long reign had political and economic corruption leading up to 1998, when the Indonesian people revolted, and the government of Soeharto was overthrown
... Show MoreThe transition states that Iraq economy lived it after 2003, and the change in tools used by monetary policy based on C.B.I law 56 in 2004, under the especially situation for the economy (structural imbalances and the weakness of banking & financial sector).
The monetary policy adopted the inflation targeting policy to mantain the monetary stability in the economy and considered it an incubator for future growth. It used the exchange rate as a nominal anchor to achieve the goal (because the rentier of economy, finance Shallowness & separation between real sector and finance sector, all this cause the normal channel to transfer the effect of monetary policy (interest rate) ineffective.
... Show MoreThere are Islamic sources and books that deal with the different doctrinal and differential framework of the Islamic religion with a monistic approach, describing them with embarrassing jurisprudential titles such as: excommunication and expiation, and epithets that carry the characteristics of hatred and rejection, in addition to removing them from the sect and religion, and the reason for that is that the doctrine (A) or (b) considers itself the doctrine that represents only the Islamic religion, and other doctrines are misguided and disbelieving. the reasons behind this - besides the attempt to establish doctrinal and fiqih rooting in claiming truth and escaping from within the foundational differential doctrinal system – is the pol
... Show MoreThis study presents an investigation about the effect of fire flame on the punching shear strength of hybrid fiber reinforced concrete flat plates. The main considered parameters are the fiber type (steel or glass) and the burning steady-state temperatures (500 and 600°C). A total of 9 half-scale flat plate specimens of dimensions 1500mm×1500mm×100mm and 1.5% fiber volume fraction were cast and divided into 3 groups. Each group consisted of 3 specimens that were identical to those in the other groups. The specimens of the second and the third groups were subjected to fire flame influence for 1 hour and steady-state temperature of 500 and 600°C respectively. Regarding the cooling process, water sprinkling was applied directly aft
... Show MoreThe determination of river pollution impact on the performance of water treatment plants is achieved by two main objectives. The first is to study raw and treated water qualities and comparing them with standards and the second is to evaluate the treatment plants efficiency. The analyzed data were those water quality parameters in relation to physical, chemical and bacteriological characteristics for river water and produced water by seven water treatment plants located on Tigris River passing through Baghdad City.
The results of this study indicated that all raw water characteristic are within the surface water standards established by Iraqi and USA criteria except Bacterial Counts.
Tigris River water is of good quality to be trea
The waste material problem in today's world has become a major topic affecting all sectors of human life. Researchers are interested in providing solutions for each kind of waste material. Waste glass is one of the waste materials whose amounts increase daily. This article deals with two types of modified cement mortar with glass granular in the masonry wall to find their effect on the wall's property (direct tensile, flexural, and compressive bond strength). Seven different mixes were prepared according to the used glass granular ratio (three mixes contained white glass with 15, 20, and 25% while three of them contained green glass granular 5, 10, and 15%, and the last mix was a controlled mix which contains no glass gr
... Show MoreThe competitive environment influences the increase in exercise intensity and hence adds to the growth of training and practice. The study objective.to identify the effect of competitive speed exercises on the effectiveness of skill performance and speed of counterattack for junior boxers, as well as to know the rate of development for these variables.Materials and methods. The research sample consisted of twelve up-and-coming Al-Najda Sports Club players who participated in the national tournament and were selected with care. They were placed into two groups, control and experimental, with six boxers each in the control and experimental groups. The two groups were assigned identical weights on purpose, and their ages range from 15 to 16 ye
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