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 Knowledge Workers is The Largest And Most Powerful Resource Of The Organizational Excellence it is A Precious Treasure, Therefore Find Organizations at present is looking for them and seek to invest their ideas For achieving excellence, creativity and access to the excellence Organizational , As a result of their importance in terms of engagement and influence in the success or failure of the as an organizational Of The Research is Measuring The Correlation And Impact Between Knowledge Workers And Organizational Excellence in Sample Of Companies Iraqi Industrial By Standing The Dimensions Of Knowledge Workers ( Characteristics , Skills , Roles , Competencies ) And
... Show MoreThe Arab-Israeli conflict passed through several stages before reaching the final stage of normalization, namely conflict, conflict and public normalization. Thus, the UAE became the third country to establish official relations with Israel after Egypt in 1979 and Jordan in 1994. With the announcement of the normalization agreement, opinions varied between supporters and opponents of the idea of normalization with Israel, and some countries expressed their acceptance of establishing official relations between the Emirates and Israel, while others warned of the consequences of normalization, which they described as treachery. Although the UAE confirmed that the normalization agreement between the two sides was credited with stopping Israel's
... Show MoreSelf-criticism is that a person confronts himself with his mistakes in order to reform and develop them for the better, motivate them and inspire hope in them to push them forward and continue to give in this life. The Holy Qur’an teaches us, through the models it cited in its verses, that this is through repentance, a feeling of remorse, and a determination to leave mistakes, and quit disobedience and sins, etc., and all this is done through constructive criticism, and at the same time, one must realize his strengths. , in order to succeed in preserving it and employing it in the right path that pleases God, His Messenger, himself and his society. This has been explained through an introduction, two topics and a conclusion, and God is t
... Show MoreReceipt date:9/1/2020 accepted date:11/24/2020 Publication date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
the Nile River and the Renaissance Dam is one of the most prominent factors that had an important role in the nature of relations between Egypt - Ethiopia, as they contributed to building a relationship that has common characteristics through the nature of the i
... Show MoreDue to the fact that living organisms do not exist individually, but rather exist in clusters interacting with each other, which helps to spread epidemics among them. Therefore, the study of the prey-predator system in the presence of an infectious disease is an important topic because the disease affects the system's dynamics and its existence. The presence of the hunting cooperation characteristic and the induced fear in the prey community impairs the growth rate of the prey and therefore affects the presence of the predator as well. Therefore, this research is interested in studying an eco-epidemiological system that includes the above factors. Therefore, an eco-epidemiological prey-predator model incorporating predation fear and
... Show MoreThe consequences of ionizing radiation-induced oxidative stress on radiographers in X-ray and CT-scan departments utilizing several biochemical were analyzed. The study found highly considerable discrepancies in the interplay between radiation levels and gender in terms of mean Malondialdehyde (MAD), Vitamin D3 (Vit.D3), Triiodothyronine (T3), Thyroxine (T4), and High-Density Lipoprotein (HDL), but not Thyroid Stimulating Hormone (TSH), cholesterol, triglyceride (TG) and Low-Density Lipoprotein (LDL). The findings indicated that malondialdehyde is a useful biomarker for assessing oxidative stress in radiographers with exposure to ionizing radiation.
Active learning is a teaching method that involves students actively participating in activities, exercises, and projects within a rich and diverse educational environment. The teacher plays a role in encouraging students to take responsibility for their own education under their scientific and pedagogical supervision and motivates them to achieve ambitious educational goals that focus on developing an integrated personality for today’s students and tomorrow’s leaders. It is important to understand the impact of two proposed strategies based on active learning on the academic performance of first-class intermediate students in computer subjects and their social intelligence. The research sample was intentionally selected, consis
... Show MoreAbstract:
In light of globalization and internationalization of financial markets, issues arising from financial crises have become increasingly serious and fundamental, creating a lot of debate among experts around the world. So, many studies have attempted to investigate what measures can be taken to detect and prevent crises before they devastate the economies.
Therefore, this paper examines the Effectiveness of the Monetary Policy (MP) to Avoid, Reduce or Treat the Financial Crisis in Malaysia. Scholars have yet to agree on the issue
... Show More
Background: Although underdeveloped in Iraq, telehealth was one tool used to continue health service provision during the COVID-19 pandemic. Aim: To assess women’s experiences and satisfaction with gynaecological and obstetric telehealth services in Iraq during the COVID-19 pandemic. Methods: Free telehealth services were provided by 4 obstetrician-gynaecologists associated with private clinics in 2020–2021. All patients who accessed the services between June 2020 and February 2021 were invited to complete a postconsultation survey on their experience and satisfaction with services. Results were analysed using descriptive statistics and logistic regression conducted using SPSS version 25. Results: A total of 151 (30.2%) women re
... Show More