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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 Jan 02 2019
Journal Name
Journal Of The College Of Languages
The Outcomes of War: A Study of the Character After the Crisis of War
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World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
The Outcomes of War: A Study of the Character After the Crisis of War
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World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.

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Publication Date
Sun Dec 27 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of factors affecting the desire of the customer and their impact on the market share in a competitive market National Insurance Company
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The research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen

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Publication Date
Wed May 01 2024
Journal Name
Journal Of Studies In Humanities And Educational Sciences
Unlocking the Language of the Heart: A Stylistic Analysis of EmotiveTechniques in Paulo Coelho's By the River Piedra I Sat Down and Wept
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This paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary

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Publication Date
Wed Dec 31 2025
Journal Name
Journal Of Studies And Researches Of Sport Education
The effect of using the educational bag on the level of learning some offensive skills with the epee weapon
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Publication Date
Mon Sep 25 2023
Journal Name
International Journal Of Energy Production And Management
Reducing Energy Consumption in Iraqi Campuses with Passive Building Strategies: A Case Study at Al-Khwarizmi College of Engineering
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University campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the

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Publication Date
Thu Dec 31 2015
Journal Name
Wuhan University Journal Of Natural Sciences
Prolactin is a Novel Biochemical Marker in Sera of Iraqi Type-2 Diabetic Women With Metabolic Syndrome in Baghdad.
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Abstract Metabolic syndrome (MS) is a group of clinical and biological abnormalities included risk of insulin resistance , disorders in glucose metabolism , abdominal obesity and abnormal lipid profile these features confer a greater risk of cardiovascular diseases . Anyway, the co-occurrence of diabetes mellitus and metabolic syndrome potentiates the cardiovascular risk associated with each of the two conditions. The present study aimed to determine a relationship between prolactin level in type -2- diabetic Iraqi women and metabolic syndrome, as well to find a relationship between prolactin level and other studied biochemical markers. seventy menopausal diabetic women with metabolic syndrome with age in range (45-50) years were enrolled i

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Publication Date
Mon Aug 01 2022
Journal Name
Baghdad Science Journal
Detection of Methamphetamine using Nanobentonite as a Novel Solid Phase Extraction Column Matrix Assisted with Gas Chromatography- Mass Spectroscopy
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          This study was done to evaluate a new technique to determine the presence of methamphetamine in the hair using nano bentonite-based adsorbent as the filler of extraction column. The state of the art of this study was based on the presence of silica in the nano bentonite that was assumed can interact with methamphetamine. The hair used was treated using methanol to extract the presence of methamphetamine, then it was continued by sonicating the hair sample. Qualitative analysis using Marquish reagent was performed to confirm the presence of methamphetamine in the isolate.The hair sample that has been taken in a different period confirmed that this current developing method can be used to analyzed methamphetamine. This m

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Publication Date
Wed Dec 31 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary C- reactive protein in relation to periodontal health among a group of patients with rheumatoid arthritis in Iraq
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Background: Rheumatoid arthritis is a chronic destructive inflammatory disease associated with destruction of joint connective tissues and bones, affecting 0.5%–1% of the population worldwide reporting higher prevalence of periodontitis among rheumatoid arthritis patients. The purpose of this study is to estimate level of salivary C-reactive protein in relation to the occurrence and severity of the periodontal disease and other oral parameters among group of patients with rheumatoid arthritis Material and methods: Fifty women patients with rheumatoid arthritis; twenty five on Methotrexate treatment and twenty five on combination treatment of Methotrexate and Etanercept selected as study groups with an age range (30-40) years old and

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality of Life for Adult Clients with Hypermobility Syndrome Attending Private Clinics in Baghdad City: A Cross-Sectional Study
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Objective)s): To evaluate the quality of life for adult clients with hypermobility syndrome at private clinics in Baghdad City. Methodology: A cross-sectional study used a purposive ‘’non-probability’’ sample of (75) adult clients with Hypermobility Syndrome (HMS) male and female who age (25-64) years. The data were collected through the utilization of standard developed questionnaire of the world health organization (WHO). Data collected by interview with each client who is involved in the study. Each interview takes approximately (20) minutes. Results: The study revealed that there is an effect of hypermobility syndrome on the quality of life, which recorded fair level in general. The study also reported that there is an effect

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