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Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associated with Acom aneurysms and provide an illustrative case.

Methods:

We combined our experience of one case of a unilaterally absent ICA associated with an Acom aneurysm with the 33 existing publications on the same subject in the literature, for a total of 40 cases. We provide a detailed systematic literature review of this association of vascular anomalies, exploring different aspects regarding the collateral pathways and how they impact management strategies and propose a management algorithm to deal with such association.

Results:

The mean age was 48.2 ± 16.5 years. The aneurysmal rupture was the most common presentation (75%). Agenesis was observed in 70% of patients, followed by hypoplasia (20%) and, finally, aplasia (10%). Lie Type A was the most common pattern of collaterals (50%), with Types B and D being of almost equal proportions. Most aneurysms were located at the A1-Acom junction contralateral to the anomalous side (Fisher’s Exact test;P= 0.03). One case of temporary clipping was reported in the literature.

Conclusion:

Acom aneurysms in patients with unilateral ICA anomalies, given they are more commonly present contralaterally, could be of acquired etiology, warranting periodic screening in asymptomatic patients. Temporary clipping might be safe in patients with Type D collateral pattern, while those with Types A or B may require intraoperative rupture risk assessment and a tailored management plan to avoid disrupting collateral flow and causing ischemia.

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Publication Date
Tue Oct 01 2013
Journal Name
Proceedings Of The International Astronomical Union
The infrared <i>K</i>-band identification of the DSO/G2 source from VLT and Keck data
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Abstract<p>A fast moving infrared excess source (G2) which is widely interpreted as a core-less gas and dust cloud approaches Sagittarius A* (Sgr A*) on a presumably elliptical orbit. VLT <italic>K<sub>s</sub></italic>-band and Keck <italic>K</italic>′-band data result in clear continuum identifications and proper motions of this ∼19<sup><italic>m</italic></sup> Dusty S-cluster Object (DSO). In 2002-2007 it is confused with the star S63, but free of confusion again since 2007. Its near-infrared (NIR) colors and a comparison to other sources in the field speak in favor of the DSO being an IR excess star with photospheric continuum emission at 2 microns than a</p> ... Show More
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Publication Date
Mon Aug 28 2023
Journal Name
Journal Of Planner And Development
The role of environmental taxation and environmental incentives to reduce environmental pollution manifestations in the urban environment
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        The aim of studying the role of environmental taxation is to reduce or mitigate the problem of environmental pollution and obtain a clean environment. And the importance of research lies in the fact that environmental taxation is one of the basic tools to achieve environmental balance. As it is considered one of the sustainable economic tools that focuses on the concept of environmental taxes and fees. Therefore, the incentives stimulated institutions to invest in clean energy and use environmentally friendly machines. Through it, the rules of the competition are updated in favor of organizations that respect the environment so that they can obtain a green competitive advantage. And that the mai

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Publication Date
Sun Aug 30 2015
Journal Name
Statistical Analysis Of The Relations Between Api,specific Gravity And Sulfur Content In The Universal Crude Oil
Statistical Analysis of the Relations between API, Specific Gravity and Sulfur Content in the Universal Crude Oil
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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using financial ratio to compare performance of the commercial and the Islamic banks Listed on Palestine Exchange
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        The research aimed to compare the performance of the commercial and the  Islamic banks listed in the Palestinian's Stock Exchange .To achieve the objectives of the study we selected all  the commercial and the Islamic banks listed in the Palestinian Stock Exchange  to obtain the necessary data for the analysis process during the period of (2009-2013) .the comparison based on the performance indicators ( liquidity rate, profitability rate ,the activity rate and the market rate).

        a statistical method was used to analyze the date to find the performance differences between the commercial banks,

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Publication Date
Tue Jun 30 2015
Journal Name
Al-khwarizmi Engineering Journal
Studying and Modeling the Effect of Graphite Powder Mixing Electrical Discharge Machining on the Main Process Characteristics
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Abstract

This paper concerned with study the effect of a graphite micro powder mixed in the kerosene dielectric fluid during powder mixing electric discharge machining (PMEDM) of high carbon high chromium AISI D2 steel. The type of electrode (copper and graphite), the pulse current and the pulse-on time and mixing powder in kerosene dielectric fluid are taken as the process main input parameters. The material removal rate MRR, the tool wear ratio TWR and the work piece surface roughness (SR) are taken as output parameters to measure the process performance. The experiments are planned using response surface methodology (RSM) design procedure. Empirical models are developed for MRR, TWR and SR, using the analysis

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Publication Date
Tue Jan 30 2018
Journal Name
International Journal Of Science And Research
The Morphological Description and Histological Structure of the Liver in Marsh Harrier Bird in Iraq (Circus aeruginosus)
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The liver of marsh harrier grossly appeared as large, bi-lobed organ divided into left and right lobes, which are approximately equal in size and not divided into secondary lobes. Histologically, the liver of marsh harrier was found to contain numerous lobules which are not well defined by the connective tissue of the septa except that surrounded the portal triads. The parenchyma of liver composed of irregular branching cords of hepatocytes organized in double rows alternating with tortures path sinusoids which are lined with flattened endothelial cells and large, irregular outlined kupffer cells. Hepatic cords arranged in a radial pattern around the central vein of the liver lobule while in a subscapsular region they run parallel to the ca

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Publication Date
Mon Jun 05 2006
Journal Name
College Of Education For Women
The Image of the Teacher in Selected Novels by Kingsley Amis Muriel Spark and C. P. Snow
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The study introduces the twentieth century background where the image of teacher is shaped by various factors according to the wide emergence of new educational institutions in the aftermath of the Second World War. A group of writers mirrored the influence of the war on educational institutions and accordingly on the image of teacher in their novels whose main action is set in and around the campus of a university. The genre dates back to the nineteen forties. where they show the foibles of human nature and reactions to external pressures. One of the early examples of this genre is Lucky Jim (1954). The image of teacher is swinged in many shapes from the tyrant to the rebellion to the defiant. All is personified in the characters of these

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Utilizing the R.E.N.A.L Nephrometry Score to predict the Surgical Technique and Peri-operative Outcomes of Renal Masses
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Background: despite the rise in the incidence of renal cell carcinoma attributed to availability of medical imaging, a considerable decline in mortality is an association. Morbidity-wise, the shift from radical nephrectomy to partial nephrectomy is the trend for now. Multiple scoring systems have been introduced over the past decades to help surgeons choose between radical and partial nephrectomy. One commonly used system is the RENAL nephrometry score that was first introduced by Kutikov and Uzzo in 2009.

Objective: to evaluate the role of RENAL nephrometry scoring system in predicting the surgical technique to use to resect renal masses and associated perioperative outcomes.

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Publication Date
Thu Jun 30 2022
Journal Name
Pakistan Journal Of Medical And Health Sciences
The Effect of Hand Blood Flow on the Peripheral Fingertip Plethysmographic Waveforms Morphology and Pulse Wave Velocity
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Photoplethysmography (PPG) is a non-invasive optical technique that employs variations in light absorption produced by alteration in the blood volume in capillaries at the skin during the cardiac cycle. This study aims to understand factors related to PPG morphology; a hand-elevation, the study has modified blood flow to and from the finger was conducted in the laboratory. It is widely established that the position of the limb relative to the heart has an effect on blood flow in arteries and venous. Peripheral digital pulse wave (DPW) signals were obtained from 15 healthy volunteer participants during hand-elevation, and hand-lowering techniques wherein the right hand was lifted and lowered relative to heart level, while the left h

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Publication Date
Thu Oct 18 2018
Journal Name
Al–bahith Al–a'alami
Watching Cultural Programs in Satellites Channels tv and Its relation to the actual reading of the book
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The research is based on an important subject according to the researchers' estimations. It is the disclosure of the nature of the relationship between Watching to cultural programs in satellite channels and the book's vision of the intellectual, and the pursuit of purchasing and acquiring it It is a scientific addition to the scientific research media because it deals in the field of new about the nature of the relationship between satellite programs and writers, and it provides a scientific development on the importance of satellite channels in the promotion of the book and sales of intellectual elite. The study examined the audience of the recipients of literature for cultural programs, the nature of the public, characteristic

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