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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
Mon Aug 01 2022
Journal Name
Baghdad Science Journal
The Association of Prothrombin Gene Mutations and Cytomegalovirus Infection with Abortion Among Iraqi Women
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Abortion is categorized as the termination of conception caused by the failure or removal of the embryo from the uterus before the conclusion of pregnancy. Microorganisms and genetic factors are two of the many factors associated with abortion. Cytomegalovirus is a widespread congenital virus infection pathogen that affects a wide variety of people. The prothrombin gene is one of the essential causes that trigger blood clotting and the function of abortion women, therefore the aim of the study is to detect and associate Cytomegalovirus and prothrombin gene mutation (Gene ID: 14061 in NCBI) with abortion through genetic and immunological methods. Five ml of whole blood was collected from an intravenous puncture and divided into two tubes,

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Publication Date
Thu Oct 01 2020
Journal Name
International Communications In Heat And Mass Transfer
Thermal behaviour of the flow boiling of a complex nanofluid in a rectangular channel: An experimental and numerical study
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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The relationship of the investment environment with the indicators of the national economy
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The investment environment is the incubator for all types of domestic and foreign investments, so if their determinants are encouraging, they increase the levels of investment flows and vice versa, as there is a relationship between the nature of the investment environment and the level of investment flows, and the determinants of the investment environment are numerous and the most important of which are security and political stability, and economic and financial factors that include relative stability In the exchange rate and inflation rates, the availability of banks and their development, transparency and integrity in administrative dealings and the lack of prevalence of administrative and financial corruption, and the clari

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Development of human resources and their role in achieving artificial intelligence A survey of the views of a sample of workers in the cement plant
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The research topic was chosen as a result of the importance of human resource in business organizations in general and the industrial process in particular. Without the human resource, business organizations cannot continue and achieve success and excellence, and the research problem has been diagnosed in the lack of sales of General Cement Company’s northern products, despite their distinctiveness, standing, and reputation in The market and its products with standard specifications, and through this problem, the following questions were raised:                                                    &nbs

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Publication Date
Tue Sep 23 2025
Journal Name
Al-adab Journal
Western Hermeneutics and Heritage: A Contemporary Study in the Debate of Understanding and Horizon.
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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The art of adornment and make-up in the ancient civilizations of Mesopotamia and the old country of Yemen as a model
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This research sheds light on those discrepancies in the use of ornaments, adornment and perfumes, as well as the art of cosmetics, in two important civilizations, namely, the Mesopotamian civilization as the earlier civilization, and the civilization of Yemen, which represents the first Arab civilization. Through the foregoing, our research includes two topics, the first topic included the history of the use of decorations, ornaments and perfumes in the civilization of Mesopotamia, while the second topic included the study of ornaments, adornment and cosmetic art in the ancient civilization of Yemen. And then the research came out with a number of conclusions that the researcher considers very important to highlight the differences and f

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Publication Date
Fri Oct 25 2024
Journal Name
The Review Of Contemporary Scientific And Academic Studies
The Representation of Men and Women in the Black and White Streams of the Second Wave of Feminism: A Corpus Stylistic Analysis
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Publication Date
Tue Feb 01 2022
Journal Name
Journal Of Engineering
Numerical analysis of a concrete foundation under a combination of a dynamic and a seismic load
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Improving in assembling technology has provided machines of higher evaluation with better resistances and managed behavior. This machinery led to remarkably higher dynamic forces and therefore higher stresses. In this paper, a dynamic investigation of rectangular machine diesel and gas engines foundation at the top surface of one-layer dry sand with various states (i.e., loose, medium and dense) was carried out. The dynamic investigation is performed numerically by utilizing limited component programming, PLAXIS 3D. The soil is accepted as flexible totally plastic material submits to Mohr-Coulomb yield basis. A harmonic load is applied at the foundation with amplitude of 10 kPa at a frequency of (10, 15 and 20) HZ and se

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Publication Date
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
A Study of Zooplankton Community in Dukan Lake, Kurdistan Region-Iraq, with a New Record of Craspedacusta sowerbii Lankester (1880) Medusa (Cnidaria: Hydrozoa)
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A study of Zooplankton community has been carried out at four selected sites on Dukan Lake. Samples of water and zooplankton were collected monthly for the period from July 2015 to February 2016. Some physical and chemical properties of water were studied and the results showed that the air temperature were ranged from 0 to 36.16 °C, water temperature ranged from 2.83 to 34.66 °C, hydrogen ion concentration of studied sites were found to lie in alkaline side, it was ranged between 6.87 to 8.57, electrical conductivity ranged from 190.79 to 850.08 µs.cm­¹, turbidity ranged from 0.9-7.7 NTU, and dissolved oxygen from 3.3 to 6.8 mg.l-¹ while BOD5 were ranged from 0.53 to 34.66 mg.l-¹. Concerning to the zooplankton, 37 species were ident

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Publication Date
Wed Jan 11 2023
Journal Name
Healthcare
Short-Term (4 Day) Effects of Oral Rinsing with Miswak and Green Tea on Gingival Crevicular Fluid Flow and IL-1β Levels: A Pilot Study
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Despite the antiplaque effect of mouth-rinsing with a combination composed of miswak (Salvadora persica L.) and green tea (Camellia sinensis var. assamica) extracts, no data are available regarding its effect on gingival tissue at the molecular level. This pilot study aimed to assess the effect of oral rinsing with this combination on gingival crevicular fluid (GCF) flow and IL-1β levels. Ten subjects rinsed with either the combination, 0.12% chlorhexidine gluconate (CHX) or distilled water without toothbrushing for 4 days after receiving baseline polishing. GCF IL-1β concentration, influx, resting volume and plaque quantity were measured at baseline and after 4 days for each intervention. No significant differences in GCF flow or

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