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.
Abstract
The research seeks to shed light on green accounting information systems, analyze them, identify sustainability reporting and how to improve it, as well as study the importance of the Iraqi oil sector, analyze it, and work on applying green accounting information systems in order to improve the quality of sustainability reporting. Oil as a branch of the General Corporation for the Distribution of Oil and Gas Products to apply the practical aspect and prove the hypothesis of the research. Explaining the company's role in improving environmental conditions
The impact of a proposal for the curriculum dictated by some of the barriers to the development of motor skillsA. M. D. Huda Ibrahim RezoukiM. M. Susan Salim DawoodIs the childhood of the most important and most fertile stage of basic education because of their significant impact in building a base on which the stated origin of sound in the early stages older age because the baby at this stage be very vulnerability to environmental factors different surroundings in which to leave their mark on his life in the stages of life other.The Gymnastics of sports long-term training, which begins between the ages very early relative to the rest of other games to reach the stage of the tournament from the age of 13-17 years almost to the women, this a
... Show MoreThis competition between competing forces, organized into axes with conflicting objectives, is reflected in all regional affairs and the goals and interests of countries within them, including Iraq. Among the most important aspects impacted by the repercussions of international and regional competition in the region is Iraqi national security, based on its vital importance in preserving the sovereignty and entity of the Iraqi state, protecting the interests and cohesion of the state and people, ensuring and defending their present and future, and interacting with various regional and international activities. The Kurdistan Region, as an important part of Iraq with its own unique characteristics, may be one of the most important regi
... Show MoreThe research aims at demonstrating the role of the formulation of the green strategy in adopting the areas of the green strategy at the level of jobs in the municipal institutions in the province of Babylon, specifically the Directorate of the municipality of Hilla. The most important areas related to the green strategy were highlighted directly or indirectly, after the indicators of environmental damage emerged from the actions of companies and institutions. The research included a sample size of 222 individual of municipal institutions with different job titles and specializations between the technical and administrative and different levels of academic achievement within the institutions within the Ministry of Construction, Ho
... Show MoreThe research dealt with the study of choice between a range of different words between the repetitive texts in the verses of the Koran and explain the reason behind this choice, and how the context has the greatest impact in this choice, and that each word in the Koran was placed in the most appropriate place, which can not be replaced by equivalent words, whatever The degree of similarity between them in the indication of the other because it remains at the end that each of those vocabulary synonyms are indicative, the first of them especially that makes the possibility of replacing them with the equivalent vocabulary impossible, and the second general significance and this connotation makes them share with their peers In one aspect of
... Show MoreThe research in Islamic history is considered a title for the glory of the nation and a mirror for the intellectual and mental maturity of the men of the Islamic state who played an important role in saving humanity from darkness to light and from ignorance to knowledge and to show their position in building the Islamic state, and to highlight the importance of their conquests of neighboring cities and the expansion of Islam, and for this reason they appear The importance of writing on the topic (The Battle of Dumat al-Jandal and its impact on the era of the Prophethood and the Rightly Guided Caliphate). The reason for choosing this topic was to show the status of Dumat al-Jandal and its importance in the Islamic state and its great role
... Show MoreIn the present study, MIG welding is carried out on low carbon steel type (AISI 1015) by using electrode ER308L of 1.5mm diameter with direct current straight polarity (DCSP). The joint geometry is of a single V-butt joint with one pass welding stroke for different plate thicknesses of 6, 8, and 10 mm. In welding experiments, AISI 1015 plates with dimensions of 200×100mm and edge angle of 60o from both sides are utilized. In this work, three main parameters related to MIG welding process are investigated, which are welding current, welding speed, heat input and plate thickness, and to achieve that three groups of plates are employed each one consists of three plates. The results indicate that increasing the weld heat input (t
... Show MoreAbstract: Background: Drug toxicity and chemotherapeutic side effects negatively impact the quality of life of breast cancer patients. Objectives: to evaluate the efficacy of pharmaceutical Interventions (PI) on quality of life (QOL)Among chemotherapy intake breast cancer women. Method: A pre-post interventional study was carried out at the chemotherapy ward of Alhabobi Hospital in Alnasiriyah City. Eligible patients received comprehensive pharmaceutical care and a self-compiled Breast Cancer Patients Medication Knowledge Guide pamphlet. Each patient received two sessions, the first at baseline and the second after 7, 14, or 21 days depending on the next taking dose of chemotherapy. Each session lasted for approximately 15-30 minutes. Par
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