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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 Jan 01 2017
Journal Name
International Journal Of Mathematics In Operational Research
A single server fuzzy queues with priority and unequal service rates
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Publication Date
Sat May 16 2009
Journal Name
Journal Of Planner And Development
Support environmental programs using knowledge management
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The research deals with Environmental Management and how to develop its programs with the use of Knowledge Management, the environmental programs that integrate with processes can add strategic value to business through improving rates of resource utilization , efficiencies , reduce waste, use risk management, cut costs, avoid fines and reduce insurance. All these activities and processes can improve it through knowledge management, the optimal usage for all organizations information , employ it in high value and share it among all organizations members who involves in modify its strategy . Choosing suitable environmental management information system, develop it and modify it with organization processes, can greatly serve the en

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
TOTAL QUALITY MANAGEMENT IN EFL EDUCATION
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The purpose of this study is to identify the extent of the EFL teachers’ implementationoftotal quality management (TQM)principles through teaching English as a foreign language in Iraqi secondary schools.A total of 180 EFL teachers fromsecondary schools in Baghdad during the academic year 2010/ 2011 participated in the study. Data was collected using a scale to identify the extent of implementation of total quality management principles by 140 EFL teachers in their classroom. To support the data collected from the scale,40 teachers were observed by EFL educational supervisors during their lessons. The collected data was analyzed using frequency, means and standard deviation to identify the extent of implementation of (TQM) principles.

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Study on Safety Construction Management Plan
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After studying the reality of application to occupational safety in new Iraqi building projects and sampling the situation wilt that in developed and neighboring countries, researcher found that there is a big gap in the level of safety application conditions, this indicates the need fora quick and clear reference for local engineers to use it on site for safety conditions in their projects . As a case study the monitors work the researcher studied a huge project in the United Arab Emirates.This project considered for safety requirements to highest grades. This case study may be far away from the projects in Iraq, but we hope to rise the Iraqi work level in the near future. After seeing the way of administration work and how they were ra

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Development human capital Across practices management
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           The objective of this research is to study the effect of human capital dimensions (knowledge, skills, abilities, value) and his management dimensions (leadership practices, employess engagement, access knowledge, workforce optimization, learning capacity) with the Office of the Inspector General's staff - the Iraqi Ministry of Culture, has depended questionnaire as a tool in data and information related to research collection, as distributed to a sample of (63) individuals were distributed in positions (director, director of the Division of employees) the search data analysis using ready-statistical program (spss) the researcher used hypothesis testing and correlation c

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Publication Date
Fri Mar 01 2019
Journal Name
Archives Of Plastic Surgery
Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods
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Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle.

Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a mod

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Publication Date
Sun Oct 01 2023
Journal Name
Journal Of Medicine And Life
Evaluating the effect of ursodeoxycholic acid (UDCA) in comparison with dexamethasone and diclofenac in a rat model of rheumatoid arthritis
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Publication Date
Mon Dec 31 2018
Journal Name
Journal Of Theoretical And Applied Information Technology (jatit)
Factors and Model for Sensitive Data Management and Protection in Information Systems’ Decision of Cloud Environment
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Journal of Theoretical and Applied Information Technology is a peer-reviewed electronic research papers & review papers journal with aim of promoting and publishing original high quality research dealing with theoretical and scientific aspects in all disciplines of IT (Informaiton Technology

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Publication Date
Wed Feb 10 2016
Journal Name
ألمؤتمر الدولي العلمي الخامس للاحصائيين العرب/ القاهرة
Proposition of Modified Genetic Algorithm to Estimate Additive Model by using Simulation
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Often phenomena suffer from disturbances in their data as well as the difficulty of formulation, especially with a lack of clarity in the response, or the large number of essential differences plaguing the experimental units that have been taking this data from them. Thus emerged the need to include an estimation method implicit rating of these experimental units using the method of discrimination or create blocks for each item of these experimental units in the hope of controlling their responses and make it more homogeneous. Because of the development in the field of computers and taking the principle of the integration of sciences it has been found that modern algorithms used in the field of Computer Science genetic algorithm or ant colo

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Engineering
Dual Stages of Speech Enhancement Algorithm Based on Super Gaussian Speech Models
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Various speech enhancement Algorithms (SEA) have been developed in the last few decades. Each algorithm has its advantages and disadvantages because the speech signal is affected by environmental situations. Distortion of speech results in the loss of important features that make this signal challenging to understand. SEA aims to improve the intelligibility and quality of speech that different types of noise have degraded. In most applications, quality improvement is highly desirable as it can reduce listener fatigue, especially when the listener is exposed to high noise levels for extended periods (e.g., manufacturing). SEA reduces or suppresses the background noise to some degree, sometimes called noise suppression alg

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