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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
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Role of Gender and Culture in Dealing with the Arab Woman's Issues Embodied in Caricatures: A Cognitive Linguistic Analysis
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Gender and culture are among the factors that influence the process of understanding and interpreting different types of communication, especially images. The current study, which is a part of a master’s thesis, aims at investigating the role of gender and culture in interpreting and understanding the caricatures that deal with women’s issues in Arab societies. To this end, the researchers adopted Barthes’ (1957) concepts of denotation and connotation in his theory of mythologies in addition to Langacker’s (1987) theory of (Domains). The research concludes that the female subjects have better cognitive abilities in investing the signs within the selected caricatures. The other factor the study reached to is that the respondents

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Publication Date
Thu Dec 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of Risk Management practices and their relationship to the Entrepreneur behavior of managers in insurance companies: applied research
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The objective of the research is to evaluate the risk management practices of the variables (risk management structure, risk management methods, key components of risk management) and their relation to the principled behavior of managers behavior(innovation, proactive, risk acceptance) By adopting the questionnaire as a main tool in collecting data from managers in the National and raq insurance companies of (50) officials Department manager, department administrator, unit administrator, and analyzed their answers using the SPSS In calculating arithmetic mean, standard deviation, percentage weight and simple correlation coefficient. The most prominent conclusions were:1.There is a positive trend in the sample in both companies and a high

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Therapeutic Use of Silymarin in the Management of Suspected Renal and Hepatic Injury Produced by NSAIDs in Osteoarthritis Patients
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Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) mostly associated with renal and hepatic adverse effects, and the adjunct use of compounds with potent protective effects, like silymarin, may be one of the choices to avoid these effects. This project was designed to evaluate the protective effect of silymarin against the suspected renal and hepatic injury induced with long term use of NSAIDs; 220 patients with osteoarthritis were randomized into 5 groups and treated with either silymarin 300mg/day alone, piroxicam 20mg/day alone, meloxicam 15mg/day alone or the combination of each of them with silymarin for 8 weeks. The renal and hepatic functions were evaluated before starting treatment and after 8 weeks including assessm

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Publication Date
Fri Jul 07 2017
Journal Name
International Journal Of Science And Research (ijsr)
Automatic brain tumor segmentation from MRI Images using superpixels based split and Merge algorithm
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RA Ali, LK Abood, Int J Sci Res, 2017 - Cited by 2

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Publication Date
Sat Dec 31 2022
Journal Name
International Journal Of Intelligent Engineering And Systems
Using Three-Dimensional Logistic Equations and Glowworm Swarm Optimization Algorithm to Generate S-Box
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Publication Date
Thu Feb 09 2023
Journal Name
Artificial Intelligence Review
Community detection model for dynamic networks based on hidden Markov model and evolutionary algorithm
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Finding communities of connected individuals in complex networks is challenging, yet crucial for understanding different real-world societies and their interactions. Recently attention has turned to discover the dynamics of such communities. However, detecting accurate community structures that evolve over time adds additional challenges. Almost all the state-of-the-art algorithms are designed based on seemingly the same principle while treating the problem as a coupled optimization model to simultaneously identify community structures and their evolution over time. Unlike all these studies, the current work aims to individually consider this three measures, i.e. intra-community score, inter-community score, and evolution of community over

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Publication Date
Fri Nov 29 2024
Journal Name
Chemical Engineering Research And Design
Comprehensive review of severe slugging phenomena and innovative mitigation techniques in oil and gas systems
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Publication Date
Sun Jan 01 2017
Journal Name
Professional Safety
Technology’s role in Safety Management
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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of The College Of Education For Women
Knowledge Management at Kindergartens Managers
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The task of an educational institution such as kindergartens need to run by managers possess the knowledge to manage the administration of the importance in the development of kindergarten has been the goal of research to identify knowledge management at Riyadh managers, and achieve the objectives of Search selected sample of directors of kindergartens in the city of Baghdad was (160) director was Akhtarhn simple random way, been building measure for knowledge management and presented to the group of experts and extracted stability in a way re-testing and Alvakronbach and reach search to a discrepancy between managers Riyadh in knowledge management and put the researcher set of recommendations including the establishment of seminars and

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Publication Date
Fri Oct 14 2022
Journal Name
المجلة العراقية لعلوم التربة
REVIEW: USING MACHINE VISION AND DEEP LEARINING IN AUTOMATED SORTING OF LOCAL LEMONS
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Sorting and grading agricultural crops using manual sorting is a cumbersome and arduous process, in addition to the high costs and increased labor, as well as the low quality of sorting and grading compared to automatic sorting. the importance of deep learning, which includes the artificial neural network in prediction, also shows the importance of automated sorting in terms of efficiency, quality, and accuracy of sorting and grading. artificial neural network in predicting values and choosing what is good and suitable for agricultural crops, especially local lemons.