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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 Nov 18 2025
Journal Name
Philosophy Journal
Critical-cultural discourse and review of political action
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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
The relationship between Intrinsic Motivation Academy and Time Management among University students
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study aimed to recognize The relationship between Intrinsic Motivation Academy and Time Management among University students and measure Intrinsic Motivation Academy And Time Management for sample and Balancing Degrees of Basic Research on the two scales According to the Variable genders and Specialization, The sample consisted (350) students by (230) female (120) male , and the sample  responded scales of Intrinsic Motivation Academy for (Alwan & Attaat2009) and Time Management (Building tool), The Results of this study show that: There are statistically significant differences according to gender variable in Intrinsic Motivation Academy and Time Management in favor of the male, and there are statistica

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Publication Date
Thu Jun 26 2025
Journal Name
Plos One
Neurologists’ perspectives on management challenges and mitigation strategies for Parkinson’s disease patients: A qualitative study in Iraq
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Background Parkinson’s disease (PD) is currently the fastest-growing neurological disorder in the world. Patients with PD face numerous challenges in managing their chronic condition, particularly in countries with scarce healthcare infrastructure. Objective This qualitative study aimed to delve into neurologists’ perspectives on challenges and gaps in the Iraqi healthcare system that influence the management of PD, as well as strategies to mitigate these obstacles. Method Semi-structured interviews were conducted with neurologists from five different Iraqi provinces, working in both hospitals and private neurology clinics, between November 2024 and January 2025. A thematic analysis approach was employed to identify the main challenge

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The integration between re-engineering and modern Approaches to reducing costs in the management of change
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       The entrance process re-engineering one of the main entrances of administrative and technology appropriate to keep pace with scientific progress and the continuing changes in business environment and for the purpose of achieving the goal sought by the organizations in the pursuit of rapid developments and renewable energy in the market competition by changing its operations and activities of the radical change which contributes to an effective contribution to reducing the cost of product or service taking into account the quality improvement in the management of change to keep the increase value and speed of placing on the market to meet customer needs and desires to achieve a

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Management of Chronic Osteomylitis
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Background : Bone infections is one of the most challenging orthopaedic complications, with considerable morbidity. There is significant impact on the life of the patients; socially, financially, physically, and mentally and it could be a limb-threatening complication. Osteomyelitis is a bone infection usually caused by bacteria, including mycobacteria, but mainly Staphylococcus aureus which is the most commonly responsible bacteria . Aim of study: To evaluate our management policy of chronic osteomylitis (C.O.M).
Methods : 32 patients presented with different types &forms of chronic osteomyelitis in many sites of long & flat bones such as tibia , femur, ,humerus ,iliac bones and knee joint , which are not response to previous

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Publication Date
Mon Dec 11 2023
Journal Name
Journal Of Kufa For Chemical Sciences
Review of Analytical Methodologies for the Determination of Metronidazole and Trimethoprim in Environmental Samples
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Antibiotics are essential for treating infectious diseases, but their overuse and adverse effects are raising concerns about global public health. The pervasiveness of antibiotic contamination in aquatic environments has drawn increased attention in recent years. The primary concern regarding the release of antibiotics into the environment is the potential for microorganisms to become resistant to antibiotics. This review article summarizes the analytical methods used to determine the presence of trimethoprim and metronidazole in various environmental samples. These antibiotics have traditionally been analyzed using tandem mass spectrometry or high-performance liquid chromatography coupled to mass spectrometry; fluorescence or ultrav

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
A Suggested Model for Using a Students Attendance Management Information Systems/ A Case Study In Lebanese French University/ Erbil
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This study aims to design unified  electronic information system to manage students attendance in Lebanese French university/Erbil, as a system that simplifies the process of entering and counting the students absence, and generate absence reports to expel students who passed  the acceptable limit of being absent, and by that we can replace the traditional way of  using papers to count absence,  with  a complete electronically system for managing students attendance, in a way that makes the results accurate and unchangeable by the students.

            In order to achieve the study's objectives, we designed an information syst

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Publication Date
Sun Jan 08 2023
Journal Name
Journal Of Planner And Development
Statistical Evaluation of the Planning Process and Scheduling Management for Irrigation and Drainage Projects in the Republic of Iraq
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The Research aims to investigate into reality in terms of planning and scheduling management process for sake the implementation and maintenance of irrigation and drainage projects in the Republic of Iraq, with an indication of the most important obstacles that impede the planning and scheduling management process for these projects and ways of addressing them and minimizing their effects.                                                  For the purpose of achieving the goal of the research, a sci

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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The effect of Analysis of internal environment in the quality of health care service survey study at AL_Elwiya Maternity Teaching Hospital
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he current research aims at showing the correlation and effect of the internal environment analysis in the quality of health service in AL_Elwiya Maternity Teaching Hospital, researcher depended on the integral method in the "analytical descriptive method" for the study of the relation between the main variables and the sub-variables throughout data collection required by the theme of this study, a case study" in tackling the data and information related to the financial aspects of the internal environment.

The problem of the study was manifested in the essential question, that is (is there internal struc

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Achieve of Marketing Superiority under the adoption of the concept of internal marketing: Applied Research at National Company for Insurance Company.
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The insurance Sector of important vessels saving that work on the accumulation of capitals which contribute to the financing of economic and social development plans of countries, in order to achieve of marketing superiority in presenting the insurance services it would require insurance companies focus their marketing efforts and increased interest in internal customer to recruitment new customers and keep of current customers, so the research aims to release the impact of the dimensions of the internal marketing of (the company's vision, training and development, incentive and, motivation, internal communication) in the dimensions of the marketing superiority (to keep the customer, service quality, customer satisfaction, customer, valu

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