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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 Nov 02 2025
Journal Name
African Arguments
From Non‑Intervention to Non‑Indifference: What the African Union Has Really Learned about Crisis Management
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Two decades after replacing the OAU, the AU’s record is best measured not by communiqués but by how fast it converts rules into results on the ground. In March 2022, the African Union’s Peace and Security Council (PSC) authorised the transition from AMISOM to ATMIS in Somalia — a reminder that, two decades after the African Union (AU) replaced the Organisation of African Unity (OAU), the Union’s rules are judged by execution, not intent. This article argues that the AU’s legal and institutional redesign shortened the warning‑to‑decision cycle and raised the credibility of enforcement, but performance still hinges on finance, logistics and political will. Where mandates are matched with money, enabling capabilities and enforc

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The extent to which governmental secondary schools' managers in al-hial province have cognitive management requirements
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The current study aims to examine the level of cognitive management requirement among the governmental secondary schools' managers in al-hial province in the kingdom of Saudi Arabia. To do this, the author designed a questionnaire comprised (20) item which was applied on (250) managers included (113) manager hold bachelor degree and (137) manager hold master degree. To carry out this study, the researcher utilized the descriptive approach. The findings revealed that a high level of cognitive management requirements among secondary schools' managers as well as there is a significant difference at the (0.05) level regarding degree type, but there is no a significant difference according to gender variable.  

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Publication Date
Tue Oct 14 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Illness Perceptions and Response to Treatment with Romiplostim in Iraqi Patients with Refractory Immune Thrombocytopenia Purpura: A Cross-Sectional Study
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Background: Immune thrombocytopenia is an immune-related disorder that causes an impairment in platelet production and stimulates platelet destruction, causing variable bleeding symptoms. Objective: This study focuses on refractory immune thrombocytopenic purpura patients on romiplostim treatment and their level of illness perception related to treatment response. Method: A cross-sectional study was conducted from May 1st, 2025, to August 1st, 2025. Brief Illness Perception Questionnaires were administered to 84 patients with ITP to collect the data. The study took place at the Hematology and Bone Marrow Transplant Center, Medical City, Baghdad, Iraq. Results: The romiplostim response rate is 21 (25.0%), while the partial response rate is 4

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
A Study of Apelin-36 and GST Levels with Their Relationship to Lipid and Other Biochemical Parameters in the Prediction of Heart Diseases in PCOS Women Patients
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This work studies the role of serum apelin-36 and Glutathione S-transferases (GST) activity in association with the hormonal, metabolic profiles and their link to the risk of cardiovascular disease (CVD) in healthy and patients' ladies with polycystic ovary syndrome (PCOS). A total of fifty-four (PCOS) patients and thirty-one healthy woman as a control have been studied. The PCOS patients were subdivided on the basis of body-mass-index (BMI), into 2-subgroups (the first group was obese-PCOS with BMI ≥ 30 and the second group was non-obese PCOS MBI<30). Fasting-insulin-levels and Lipid-profile, Homeostatic-model assessment-of-insulin-resistance (HOMA-IR), follicle-stimulating-hormone (FSH), luteinizing-hormone (LH), testosterone and

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Publication Date
Thu Oct 22 2026
Journal Name
Journal Of Administration And Economics
Using the Maximum Likelihood Method with a Suggested Weight to Estimate the Effect of Some Pollutants on the Tigris River- City of Kut
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The aim of this research is to use robust technique by trimming, as the analysis of maximum likelihood (ML) often fails in the case of outliers in the studied phenomenon. Where the (MLE) will lose its advantages because of the bad influence caused by the Outliers. In order to address this problem, new statistical methods have been developed so as not to be affected by the outliers. These methods have robustness or resistance. Therefore, maximum trimmed likelihood: (MTL) is a good alternative to achieve more results. Acceptability and analogies, but weights can be used to increase the efficiency of the resulting capacities and to increase the strength of the estimate using the maximum weighted trimmed likelihood (MWTL). In order to perform t

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Publication Date
Mon Jan 01 2024
Journal Name
Studies In Systems, Decision And Control
The Effect of Using an Accounting Information System Based on Artificial Intelligence in Detecting Earnings Management to Enhance the Sustainability of Economic Units
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This research aims to clarify the importance of an accounting information system that uses artificial intelligence to detect earnings manipulation. The research problem stems from the widespread manipulation of earning in economic entities, especially at the local level, exacerbated by the high financial and administrative corruption rates in Iraq due to fraudulent accounting practices. Since earning manipulation involves intentional fraudulent acts, it is necessary to implement preventive measures to detect and deter such practices. The main hypothesis of the research assumes that an accounting information system based on artificial intelligence cannot effectively detect the manipulation of profits in Iraqi economic entities. The researche

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Energy Storage
A hybrid solidification enhancement in a latent-heat storage system with nanoparticles, porous foam, and fin-aided foam strips
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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Implementation of the Coronavirus Prevention Standards (Covid-19) In the Kingdom Of Saudi Arabia (A COMPARATIVE STUDY BETWEEN FAMILIES OF PEOPLE WITH INTELLECTUAL DISABILITIES AND FAMILIES OF ORDINARY PEOPLE)
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The study aims to identify the degree of implementation of the coronavirus prevention standards (covid-19) in the kingdom of Saudi Arabia and compare it with the families of intellectual disabilities. The study population consisted of all families residing in the Kingdom of Saudi Arabia. To achieve the objectives of the research, the analytical descriptive approach was employed. The study sample consisted of (372) families, among them (84) families with intellectual disabilities, and (288) families without intellectual disabilities. They were chosen from the Saudi community according to what is available for collection in a simple random way, using the standard criteria for the prevention of coronavirus (Covid- 19) Prepared by the resear

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Publication Date
Thu Dec 27 2018
Journal Name
Revue Académique De La Recherche Juridique
The Scope of the Judge’s Authority in Completing a Contract and the Limitations Thereon – A Comparative Study
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The contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.

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Publication Date
Sat Sep 01 2007
Journal Name
Al-khwarizmi Engineering Journal
Free Convective Heat Transfer with Different Sections Lengths Placed at the Exit of a Vertical Circular Tube subjected to a Constant Heat Flux
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A free convective heat transfer from the inside surface of a uniformly heated vertical circular tube has been experimentally investigated under a constant wall heat flux boundary condition for laminar air flow in the ranges of RaL from 6.9108 to 5109. The effect of the different sections (restrictions) lengths placed at the exit of the heated tube on the surface temperature distribution, the local and average heat transfer coefficients were examined. The experimental apparatus consists of aluminum circular tube with 900 mm length and 30 mm inside diameter (L/D=30). The exit sections (restrictions) were included circular tubes having the same inside diameter as the heated tube but with different lengths of

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