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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
Tue Jun 01 2010
Journal Name
Journal Of The College Of Languages (jcl)
Nature of a holy book in the poetry of Ibn Arabi Mohi
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The paper discusses the lack of a uniform definition of politeness due to the constant tension between its universality and language specificity, and argues that some of the theoretical debate could be resolved if the distinction between politeness as a commonsense notion and politeness as a theoretical construct were clearly addressed and acknowledged in the research.

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Publication Date
Sat Mar 01 2025
Journal Name
Basic Education College Magazine For Educational And Humanities Sciences
The Transformation of Power: A Study of Coriolanus from Soldier to Statesman
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William Shakespeare's play Coriolanus explores the journey of power and the transformation of a skilled warrior into a statesman. This paper employs Machiavelli’s framework of pragmatic statecraft to analyse Coriolanus’s tragic failure as a political leader despite his unparalleled prowess as a Roman general. It analyses Coriolanus's political career, revealing how his military skills, while effective in warfare, do not translate into political success. The paper shows that Coriolanus’s contempt for performative politics, refusal to adopt civic diplomacy, and failure to soften aristocratic pride with populist appeal turn plebeians against him and alienate patricians. His upholding of martial honour — fostered by his mother Volumnia

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Publication Date
Sat Apr 01 2023
Journal Name
International Journal Of Modern Physics E
Hamiltonian sensitivity in calculating the electromagnetic moments and electroexcitation form factor for the <i>sd</i> nuclei using shell model with Skyrme–Hartree–Fock
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In this work, the nuclear electromagnetic moments for the ground and low-lying excited states for sd shell nuclei have been calculated, resulting in a revised database with 56 magnetic dipole moments and 41 electric quadrupole moments. The shell model calculations are performed for each sd isotope chain, considering the sensitivity of changing the sd two-body effective interactions USDA, USDE, CWH and HBMUSD in the calculation of the one-body transition density matrix elements. The calculations incorporate the single-particle wave functions of the Skyrme interaction to generate a one-body potential in Hartree–Fock theory to calculate the single-particle matrix elements. For most sd shell nuclei, the experimental data are well rep

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Publication Date
Wed Jan 15 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The responsibility of the administration in compliance with the going concern assumption during the preparation for their financial statements: Research practically at muster of companies
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This research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio

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Publication Date
Sun Nov 19 2017
Journal Name
Iraqi Journal Of Laser
Effects of Diode Laser 940 nm with and without 5 % Sodium Fluoride White Varnish with Tri-calcium Phosphate on Dentin Permeability (In vitro study)
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It is found that hypersensitive teeth have a larger number and wider patent tubules than those of non-sensitive teeth. Objective: The aim of this study is to compare between the effects of diode laser at different power densities, with and without sodium fluoride on the sealing of exposed dentinal tubules and dentin permeability. Materials and methods: 118 teeth were used. Samples were divided into three major groups. The first consisted of 100 teeth used for permeability test. The second consisted of 16 teeth for measuring external surface temperature elevation while irradiation. The third, in turn, consisted of one pair of teeth observed under SEM for dentine surface morphology analysis. Results: For dentin permeability measurement, th

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Publication Date
Sat Dec 01 2018
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Design and Implementation of a Contactless Smart House Network System
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The Internet of Things (IoT) technology is every object around us and it is used to connect these objects to the Internet to verify Machine to Machine (M2M) communication. The smart house system is the most important application of IoT technology; it is increase the quality of life and decrease the efforts. There were many problems that faced the existing smart house networking systems, including the high cost of implementation and upgrading, high power consumption, and supported limited features. Therefore, this paper presents the design and implementation of smart house network system (SHNS) using Raspberry Pi and Arduino platforms as network infrastructure with ZigBee technology as wireless communication. SHNS consists of two mai

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Publication Date
Sun May 05 2024
Journal Name
Review Of Clinical Pharmacology And Pharmacokinetics - International Edition
Isolation and characterization of a tetrahydroprotoberberine alkaloid from Crassula ovata
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The presence of alkaloids in Crassula ovata is a topic that is still unexplored, as there are no published studies on the matter. This study demonstrates the presence of an alkaloid compound (and its class) for the first time in Crassula ovata. The plant material was defatted with n-hexane, and a Soxhlet apparatus was used for the extraction process, while the acid-base method was used for the isolation of alkaloids from the chloroform fractions. The quaternary alkaloid was precipitated from the aqueous layer spontaneously, in high quantity. By using standard spectroscopic methods (including liquid chromatography - mass spectroscopy) we were able to clarify the structure of the precipi¬tated compound as a tetrahydroprotoberberine a

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Publication Date
Tue Jun 11 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and Characterization of Etodolac as a Topical Nanosponges Hydrogel
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Nanosponges (NS) of etodolac(ETO) was prepared using the emulsion solvent diffusion method ; the effects of drug: polymer ratio, the effect of level concentration of internal phase and stirring time and other variables that effect on the physical characteristics of NS were investigated and characterized, The selected formula was lyophilized then incorporated into hydrogel ; which also evaluated .The results show that the formulation that contain Drug: PVA:EC in ratio 1:3:2 is the best with smallest particle size 40.2±0.098 with polydispersibility0.005 and in vitro release 97.6±0.11%, , ETO NS Carbopol hydrogel produced a significant(p<0.05) improvement of the in vitro release than pure ETO hydrogel.

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Publication Date
Thu May 25 2023
Journal Name
Eureka: Physics And Engineering
Design, analysis and construction of a simple pulse duplicator system
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One of the most important human diseases that need to be considered in terms of development of the medical engineering devices is cardiovascular disease which is a significant cause of death globally recently. Valvular heart disease is normally treated by restoring or altering heart valves with an artificial one. But the new prosthetic valve designs necessitate testing for durability estimate and failure method. It is significant to simulate the circulation system by the building of a pulse duplicator system. This study is stated by clarifying the parameter and implementation steps of the pulse duplicator system in which the different researchers have utilized the system and tried to explain the design steps of using this system wit

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Publication Date
Mon Apr 09 2018
Journal Name
Al-khwarizmi Engineering Journal
Construction and Evaluation of a Uniaxial Mechanical Actuated Vibration Shaker
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In the present paper a low cost mechanical vibration shaker of rotating unbalanced type with uniaxial shaking table was designed and constructed in an attempt to provide opportunities for experimental testing and application of vibration in experimental modal analysis, stress relief of weldments, effect of vibration on heat transfer and seismic testing of civil engineering structures. Also, it provides unexpressive solution to enhance the knowledge and technical skills of students in mechanical vibration laboratory. The shaker consists of a five main parts shaker frame, shaker table, flexible support, drive motor, and eccentricity mechanism. The experimental results show that the amplitude of the shaker is increased with increasing the f

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