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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 May 01 2018
Journal Name
Journal Of Engineering Science And Technology
A proposed dual size design for energy minimization in sub-threshold circuits
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Sub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A Proposed Audit Program for Lease Contracts in Insurance Companies Applying (IFRS16)
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Abstract:

                 The research aims to clarify the impact of adopting the IFRS16 financial reporting standard on lease contracts in insurance companies on audit procedures. The change in the classification of lease contracts in the case of adopting the IFRS16 financial reporting standard necessarily requires audit procedures that are compatible with this change. A proposed audit program was prepared, guided by international auditing standards, based on the study of the client's environment and analysis of external and internal risks in the light of financial and non-financial indicators. The researchers reached a set of concl

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Publication Date
Fri Apr 01 2022
Journal Name
Baghdad Science Journal
Improved Firefly Algorithm with Variable Neighborhood Search for Data Clustering
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Among the metaheuristic algorithms, population-based algorithms are an explorative search algorithm superior to the local search algorithm in terms of exploring the search space to find globally optimal solutions. However, the primary downside of such algorithms is their low exploitative capability, which prevents the expansion of the search space neighborhood for more optimal solutions. The firefly algorithm (FA) is a population-based algorithm that has been widely used in clustering problems. However, FA is limited in terms of its premature convergence when no neighborhood search strategies are employed to improve the quality of clustering solutions in the neighborhood region and exploring the global regions in the search space. On the

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Scale-Invariant Feature Transform Algorithm with Fast Approximate Nearest Neighbor
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There is a great deal of systems dealing with image processing that are being used and developed on a daily basis. Those systems need the deployment of some basic operations such as detecting the Regions of Interest and matching those regions, in addition to the description of their properties. Those operations play a significant role in decision making which is necessary for the next operations depending on the assigned task. In order to accomplish those tasks, various algorithms have been introduced throughout years. One of the most popular algorithms is the Scale Invariant Feature Transform (SIFT). The efficiency of this algorithm is its performance in the process of detection and property description, and that is due to the fact that

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
CA 27-29: A Valuable Marker for Breast Cancer Management in Correlation with CA 15-3
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Publication Date
Mon Aug 16 2021
Journal Name
TÜrkÇe SÖzlÜkte Tdk Yer Alan ArapÇa Kelİmeler Üzerİne Bİr Anlam Bİlİmİ İncelemesİ
A SEMANTICS REVIEW ON THE ARABIC WORDS IN THE TURKISH DICTIONARY (TDK)
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Publication Date
Sat Aug 01 2020
Journal Name
Key Engineering Materials
Systematic Design of Short-Span Segmental Beams Reinforced by CFRP Plates
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The main objective of this study is to introduce a systematic design procedure for short-span segmental beams following a sophisticated ACI 440.2R-17 design procedure. The general aspects of innovative short-span segmental beams are easy to fabricate, economical and rapidly placed in pre-specified positions. Short-span segmental beams fabricated from individual precast plain-concrete blocks and CFRP plates. Recently, experimental tests performed on short-span segmental beams, by the authors, investigated CFRP plate-bonding, CFRP plate cross-sectional area, the thickness of plate-bonding epoxy resin, surface-to-surface condition of concrete blocks, as well as, interface condition of the bonding surface. The experimental program comprises tes

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Branch and Bound Algorithm with Penalty Function Method for solving Non-linear Bi-level programming with application
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The problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.

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Publication Date
Tue Mar 03 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Administrative performance and its relationship with the cognitive style (rigidity - flexibility) for management body members of the sport clubs
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Publication Date
Sun Jan 01 2023
Journal Name
Corporate And Business Strategy Review
The role of learning organizations in crisis management strategy: A case study
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The problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea

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