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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
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
Individualism and the Symbolic Language of Imagination (Pablo Neruda as an Example)
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Pablo Neruda's artistic distinctiveness can be considered in two ideas or attitudes of romanticism. First, the imagination, which is the result of conduct and spirituality, and second, the individualism, which is a collection of mysterious mysteries from the texts of individuality based on philosophical sonnets. His collection of poems points out the ethereality and indescribability of life, employing the reality of life at the level of human perception in a symbolic language. In other words, Pablo Neruda recreates the meanings in poetry through the three ideas of reduction, interpretation, and analysis. "What is the essential connection between individualism and the symbolic language of Pablo Neruda's imagination and What are the reason

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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
Thu Aug 17 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Amorphological and histological study of the olfactory organ in Parasilurus triostegus (Heckel)
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The morphological description and histological structure of the

olfactory     organ     of    Parasilurus     triostegus     (Heckel)     have    been

investigated. The olfactory organ situated on the dorsal surface of the

head infront of the eye.

It  is  represented   by  elongated  olfactory  sac,  in  which  the

olfactory Lamellae arranged as Rosette- like pattern .

The olfactory sac connected with the olfactory bulb by short olfactory nerve. The olfactory bulb which situated near the olfactory sac connected wi

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
The Level of Nitric Oxide Synthase and Nitric Oxide in Hypertensive Women
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Hypertension is a cardiovascular problem with high rates of epidemiology and risks of morbidity and mortality in the global area. Nitric oxide (NO) is one of the reactive oxygen species (ROS) that produced from L-arginine by nitric oxide synthase (NOS) enzyme. NO involves in various vital processes in human health, one of which is the modulation of vasoconstriction and relaxation of the vascular system. We have aimed to investigate the link between NO and NOS with hypertension in women. The relationship between NO and NOS, as well as the usefulness of them as indicators of hypertension risks were subjects of study in this article. The results have revealed that hypertensive women had significant (P<0.05) lower levels of NO (15.07±3.41 IU/m

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Engineering
Experimental Investigations on the Strength and Serviceability of Biaxial Hollow Concrete Slabs
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Biaxial hollow slab is a reinforced concrete slab system with a grid of internal spherical voids included to reduce the self-weight. This paper presents an experimental study of behavior of one-way prestressed concrete bubbled slabs. Twelve full-scale one-way concrete slabs of (3000mm) length with rectangular cross-sectional area of (460mm) width and (150mm) depth. Different parameters like type of specimen (solid or bubbled slabs), type of reinforcement (normal or prestress), range of PPR and diameter of plastic spheres (100 or 120mm) are considered. Due to the using of prestressing force in bubbled slabs (with ratio of plastic sphere diameter D to slab thickness H, D/H=0.67), the specimens showed an increase in ultimat

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Publication Date
Sun May 07 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The Study of Electric Quadrupole Transition (E2) in 56Ba and 62Sm Nuclei
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Transition strengths ↓
2
. u . w
2) M(E for gamma transition from first excited 21
+
states to the
ground states that produced by pure electric quadrupole emission in even –even isotopes of
56Ba and 62Sm have been studied through half- lives time for 21
+
excited states with the
intensities of γ0- transitions measurements and calculated as a function of neutron number
(N). The results thus obtained have shown that; the nuclides with magic neutron number such
as 56Ba
138
and 62Sm
144
have minimum value for ↓
2
. u . w
2) M(E .

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Histological and Histochemical study of the Esophagus in Laughing Dove Streptopelia senegalensis
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The present study represent the histological and histochemical structure of the esophagus of laughing dove Streptopelia senegalensis, one of the wild birds, which feed on the seeds( grainvorous).The result showed that the esophagus long tubular quit wide and highly distensible organ situated at the right side of the nick , lie between pharynx and stomach it was divided into cervical and thoracic part , the cervical part longer than the thoracic part, and the crop was merely enlargement fusiform in shape which located at the entrance of the thorax. Esophagus parts showed that composed of four layer ;the mucosa, sub mucosa, muscular and adventitia or serosa, the mucosal layer was arranged in folds which was longer in the c

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
The strategy of spreading extremism and its impact on Egypt regional role
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ABSTRACT The importance and objectives of the study were an attempt to understand the methodology of disseminating radical thought and the reasons of social acceptability that make young people embrace this thought. It also sheds light on the impact of this phenomenon on the regional role of Egypt and examines the strategic means and standards that the Egyptian state focuses on in immunization and prevention of extremism.

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Publication Date
Thu Aug 06 2020
Journal Name
Cuestiones Políticas
Political structure and the administration of political system in Iraq (post-ISIS)
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The objective of the investigation was to analyze the structure and administration of the political system in Iraq (post-ISIS). After 2003, the Iraqi political system suffered the fundamental problem of its failure to achieve the political and social inclusion that characterizes democratic systems, to guarantee the establishment of a "state for all", while respecting differences. Political representation has moved from the system of sectarian ethnic components, under the title of consensual democracy, to the representation of leaders and the realization of their interests and the interests of their parties at the expense of the groups that claim to represent them, which complicates the problem. In this sense, the new political syste

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