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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
Fri Sep 29 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of The Effect of Fisetin against Cyclophosphamide-Induced Myelosuppression and Oxidative Stress in Male Albino Rats
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Myelosuppression is a serious disease that is related to the malfunction of blood cells production that leads to cytopenia which is the most serious hematologic toxicity of cancer chemotherapies including cyclophosphamide, which is a strong oxazaphosphorine [a nitrogen mustard alkylating agent] that can be used alone or combined with other chemotherapeutic agents for the treatment of different malignant diseases. It induces severe bone marrow suppression by damaging hematopoietic stem cells through the generation of oxidative stress. Fisetin is a hydrophobic polyphenolic compound with a wide range of pharmacological properties such as antioxidant, anti-inflammatory, antimicrobial, osteoprotective, antidiabetic, and anti-carcinogenic

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role of strategic Agility in organizational excellence In Ministry of Construction, Housing, Municipalities and Public Works
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The aim of this research is to identify the role of strategic agility achieving organizational excellence in one of the formations of the Ministry of Municipalities (Dhi Qar Sewage Directorate), as important service organizations that have a key role in serving and developing the society which faced many administrative challenges and issues and as a result of the changes in the environment is continuing and accelerating, so the adoption of modern administrative concepts such as strategic Agility and knowledge of their role in achieving organizational excellence can help them in facing these changes and achieve what they aspire to. In order to achieve research objectives, two main hypotheses have been formulated. The first hypothe

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Publication Date
Thu Nov 18 2021
Journal Name
Healthcare
Effect of Practice Environment on Nurse Reported Quality and Patient Safety: The Mediation Role of Person-Centeredness
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This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 pati

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Publication Date
Fri Jan 24 2025
Journal Name
Karbala International Journal Of Modern Science
Chemistry of Metalloguanines: An Overview of Their Synthesis Routes and Their Implementations for the Period 2000-2024
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Guanine has a variety of roles in chemistry, from its basic function in the storing and transferring genetic information to its usages in synthetic chemistry and other fields. Because of its distinct structure and biological importance, it is a fundamental component of contemporary study in organic chemistry and molecular biology. In this review, we focused on covering the synthetic pathways of various derivatives of guanine from the year 2000 until the present. As a result of the guanine molecule containing multiple functional groups, this gives us the ability to prepare several guanines such as O6-alkylating guanines, O6-benzylguanines, 8-aza-O6-benzylguanines, 9-substituted guanines, guanine-azo derivatives, guanine Schiff bases, guanin

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Publication Date
Mon Nov 14 2022
Journal Name
Journal Of Reinforced Plastics And Composites
Effect of phosphoric acid molarity on the structural, thermal, mechanical, and electrical properties of polyimide/polyaniline nanocomposites
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In this paper, we used two monomers, 3,3',4,4'-benzophenone tetracarboxylic dianhydride (BTDA) and m,m'-diaminobenzophenone (m, m’-DABP), to produce polyamide acid and then converted it to polyimide (PI). The effects of phosphoric acid (H3PO4) molarity (1, 2, and 3 M) on the structural, thermal, mechanical, and electrical characteristics of the polyimides/polyaniline (PI/PANI) nanocomposites were studied. Two sharp reflection peaks were developed by the addition of PANI to PI. When 3 M H3PO4 is added, the crystalline sharp peak loses some of its intensity. The complex formation of PI/PANI-H3PO4 was confi

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Publication Date
Thu Aug 08 2024
Journal Name
Computation
Evaluation of the Dynamics of Psychological Panic Factor, Glucose Risk and Estrogen Effects on Breast Cancer Model
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Contracting cancer typically induces a state of terror among the individuals who are affected. Exploring how glucose excess, estrogen excess, and anxiety work together to affect the speed at which breast cancer cells multiply and the immune system’s response model is necessary to conceive of ways to stop the spread of cancer. This paper proposes a mathematical model to investigate the impact of psychological panic, glucose excess, and estrogen excess on the interaction of cancer and immunity. The proposed model is precisely described. The focus of the model’s dynamic analysis is to identify the potential equilibrium locations. According to the analysis, it is possible to establish four equilibrium positions. The stability analys

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Publication Date
Thu Nov 21 2013
Journal Name
Pharmaceutical Development And Technology
Effect of ethylcellulose and propylene glycol on the controlled-release performance of glyceryl monooleate–mertronidazole periodontal gel
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Publication Date
Sat Jan 02 2021
Journal Name
Kerbala Journal Of Pharmaceutical Sciences
Study the Effect of Disintegrant Types on Preparation and In-Vitro Evaluation of Salbutamol Sulfate Effervescent Granules
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Publication Date
Mon Jan 01 2024
Journal Name
Computers, Materials & Continua
Improving Video Watermarking through Galois Field <i>GF</i>(2<sup>4</sup>) Multiplication Tables with Diverse Irreducible Polynomials and Adaptive Techniques
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Publication Date
Tue Sep 17 2024
Journal Name
Evolutionary Studies In Imaginative Culture
The Effect of the Siberian Air Altitude on the Characteristics of the Climate of the Northern Arabian Peninsula
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The field of climatic geography focuses on the study of the Earth's surrounding atmosphere, particularly the lower (surface) part close to the Earth's surface. This field examines the interactions within the atmosphere resulting from the solar radiation that reaches the Earth and the subsequent distribution of atmospheric pressure. Consequently, certain surface pressure systems, both high and low, emerge and vary in their temporal and spatial impacts on the climate of the Arabian Peninsula. Therefore, it is essential to conduct a comprehensive and detailed study to understand the causes, development, movement, geographical distribution, and monthly and seasonal recurrence of these pressure systems. For this purpose, a minor climatic

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