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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
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia
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Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav

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Publication Date
Thu Jan 11 2024
Journal Name
Научный Форум
Structural and semantic features of military metaphors in the modern Russian press
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Publication Date
Thu Aug 20 2020
Journal Name
Al-mustansiriyah Journal Of Science
The Importance of 2-AminoThiazole Schiff Bases as Antimicrobial and Anticancer Agents
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The pharmacophore 2-aminothiazole has an interesting role in pharmaceutical chemistry as this led to the synthesis of many types of compounds with diverse biological activity. Schiff base derivatives at the same time contribute to drug evolution importantly. In this review, the Schiff base derivatives of 2-aminothiazole formed and some of their metal complexes are being focused on, and the antimicrobial and anticancer activity of them is being illustrated.

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Publication Date
Wed Mar 01 2023
Journal Name
Shift
Construction Safety Personnel Qualifications: The Impact of Education, Experience, and Certificate Programs
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Publication Date
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
Blindness and the Critique of Society: Dystopia in “Blindness” by José Saramago""
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This paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopian so

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Research and Development Programs Effectiveness in the Central Library of Baghdad University
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Research and Development Programs Effectiveness in the Central Library of Baghdad University

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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
Baysian and NonBaysian Methods to Estimate the two parameters of Logistic Distribution
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In this paper ,the problem of point estimation for the two parameters of logistic distribution has been investigated using simulation technique. The rank sampling set estimator method which is one of the Non_Baysian procedure and Lindley approximation estimator method which is one of the Baysian method were used to estimate the parameters of logistic distribution. Comparing between these two mentioned methods by employing mean square error measure and mean absolute percentage error measure .At last simulation technique used to generate many number of samples sizes to compare between these methods.

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Publication Date
Thu Jan 03 2008
Journal Name
Kufa Med. Journal
Synrgistic Activity of Peganum Harmala Extract and Pentostam on the Leishmania Donovania
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The Effect of Eruca sativa extract on Gram Posative and Negative Bacteria
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The antibacterial effect of (Eruca sativa) extract was evaluated by an in vitro study testing the growth of various Gram-Positive and Gram-Negative bacteria . The bactericidal activity of this extract was analyzed by serial dilution in tubes. This study,found that Gram-Negative and Gram-Positive bacteria susceptible to very low eruca concentrations. On the other hand, Gram-positive bacteria were more susceptible than Gram-negative bacteria, the minimal bactericidal concentration of Gram-positive bacteria was 5 mg ml-1 but minimal bactericidal concentration of Gram-negative bacteria was 10 mg ml-1 that mean duble inhibation concentration of Gram-positive bacteria . this study suggest that Eruca sativa leaves have inhibation effect on Gra

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Publication Date
Sat Aug 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Achieving the Benefits and Requirements of Integrated Project Delivery Method Using BIM
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Abstract<p>Through the last decade, Integrated Project Delivery (IPD) methodology considers one of the new contractual relations that are also on the way to further integrate the process of combining design and instruction. On the other hand, Building Information Modeling (BIM) made significant advancements in coordinating the planning and construction processes. It is being used more often in conjunction with traditional delivery methods. In this paper, the researcher will present the achievement of IPD methodology by using BIM through applying on the design of the financial commission building in Mayssan Oil Company in Iraq. The building has not been constructed yet and it was designed by usin</p> ... Show More
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