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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
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Total Quality Management in Insurance: Companies Field Study in Iraqi Insurance Company
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Total quality management is considered a modern management concept that achieved success in all fields of various industrial and service sectors in advanced countries . One of these sectors is insurance. This concept aims at improving and developing the performance of insurance service continually . It is the gate that can enable radical change in the organization culture inside the company to transform it from using the traditional management style into using the modern style which achieves high quality standard of insurance service . As a result many insurance companies headed to applying the principles of total quality management in their companies . This study aims at raising the standard of the performance of the Iraqi Insurance Com

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Publication Date
Sun Nov 01 2020
Journal Name
International Journal Of Engineering
Pavement Maintenance Management Using Multi-objective Optimization: (Case Study: Wasit Governorate-Iraq)
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Publication Date
Sun Oct 19 2025
Journal Name
Lecture Notes In Networks And Systems
Smart Management for Secondary School Principals in Education Directorates from Their Viewpoint
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The research aimed to identify smart management capabilities of secondary school principals in education directorates in Baghdad according to the administrative intelligent and leadership competencies. The study used incentives as a descriptive method, by analyzing five main areas of smart management: strategic planning, self-awareness, skills, organization and culture. A purposive sample consisting of 102 secondary school principals from education directorates (Rusafa1) and (Karkh2), was taken to fill questionnaire the latter representing a complete sample of the target population. validated has been built an advanced measurement tool composed of 56 items across the five domains of strategic planning (21%), self-awareness (21%), culture (2

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Publication Date
Sat Jan 01 2022
Journal Name
Computers, Materials & Continua
An Optimal Method for Supply Chain Logistics Management Based on Neural Network
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Publication Date
Fri Oct 23 2020
Journal Name
Biomed Research International
A Computational Model of the Brain Cortex and Its Synchronization
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Obtaining the computational models for the functioning of the brain gives us a chance to understand the brain functionality thoroughly. This would help the development of better treatments for neurological illnesses and disorders. We created a cortical model using Python language using the Brian simulator. The Brian simulator is specialized in simulating the neuronal connections and synaptic interconnections. The dynamic connection model has multiple parameters in order to ensure an accurate simulation (Bowman, 2016). We concentrated on the connection weights and studied their effect on the interactivity and connectivity of the cortical neurons in the same cortical layer and across multiple layers. As synchronization helps us to mea

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Publication Date
Mon Apr 08 2024
Journal Name
Fifth International Conference On Applied Sciences: Icas2023
Bifurcation analysis of the role of good and bad bacteria in the decomposing toxins in the intestine with the impact of antibiotic and probiotics supplement
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This study presents a mathematical model describing the interaction of gut bacteria in the participation of probiotics and antibiotics, assuming that some good bacteria become harmful through mutations due to antibiotic exposure. The qualitative analysis exposes twelve equilibrium points, such as a good-bacteria equilibrium, a bad-bacteria equilibrium, and a coexisting endemic equilibrium in which both bacteria exist while being exposed to antibiotics. The theory of the Sotomayor theorem is applied to study the local bifurcation around all possible equilibrium points. It’s noticed that the transcritical and saddle-node bifurcation could occur near some of the system’s equilibrium points, while pitchfork bifurcation cannot be accrued at

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Publication Date
Thu Mar 03 2022
Journal Name
Archives Of Rheumatology
Association of tumor necrosis factor-alpha promoter region gene polymorphism at positions -308G/A, -857C/T, and -863C/A with etanercept response in Iraqi rheumatoid arthritis patients
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Objectives: This study aims to evaluate the association between polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at locations -308G/A, -857C/T, and -863C/A with the tendency of being non-responder to etanercept.

Patients and methods: Between October 2020 and August 2021, a total of 80 patients (10 males, 70 females; mean age: 50 years; range, 30 to 72 years) with rheumatoid arthritis (RA) receiving etanercept for at least six months were included. The patients were divided into two groups responders and non-responders, based on their response after six months of continuous treatment. Following polymerase chain reac

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Publication Date
Fri Dec 23 2022
Journal Name
F1000research
Association between polymorphisms within the gene coding for tumor necrosis factor (TNF)-alpha with outcomes of treatment in a sample of Iraqi patients with ankylosing spondylitis taking etanercept: an observational study
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Background:Ankylosing spondylitis (AS) is a progressive, chronic inflammatory illness with an unclear etiology that explicitly targets the vertebral column, peripheral joints, and extraarticular tissues. The purpose of this research was to investigate if the existence of single nucleotide polymorphisms (SNPs) in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at positions -1031T/C (rs199964), -857C/T (rs1799724) and -806C/T (rs4248158) in a sample of Iraqi AS patients could influence the patients' outcomes with etanercept.

Methods:Sixty patients with established AS receiving only etanercept were selected to enroll in this study, with a mean age of 40.75±8.6

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Publication Date
Mon Dec 13 2021
Journal Name
International Journal Of Reproductive Biomedicine (ijrm)
Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study
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Background: Repeated teenage pregnancy is a major burden on the healthcare system worldwide. Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications. Materials and Methods: This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and thi

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
Isolation and Purification of a Cyclooxygenase-2 from the Blood of a Patient Suffering from Rheumatoid Arthritis and Studying the Effect of Natural Products of the Soapwort on the Activity of Purified Enzyme
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In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni

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