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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
Sun Oct 01 2017
Journal Name
Journal Of Craniofacial Surgery
Is Orbital Floor Reconstruction With Titanium Mesh Safe?
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The variation of the Firm’s value considering the relationship between the financial structure and earnings per share
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The current research aims to determine the relationship of the impact of the components of the financing structure, especially financing through debts, as well as the earnings per share in the value of the shares of companies listed in the Iraq Stock Exchange. The research sample and identifying the strength of the combined effect of the ratio of financing through debt and earnings per share in maximizing The market value of the firm and the real value, as well as the variation between these relationships according to model of the real value of the companies and the market value of the research sample companies. The research community is represented by the Iraq Stock Exchange, while a conditional deliberate sample

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Shortcomings mentioned by the Torah about the prophet Lot in the prophecies and the respond of Quran
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Praise be to Allah , and peace and blessings of God sent mercy to the worlds Muhammad
Amin and his family and his friends and followers to the Day of Judgement .
Savants Jews worked to distort the Torah calamity on the Prophet Moses ( peace be upon
him ) to achieve their goals and objectives , which are decorating sin to their followers , and
spreading corruption on earth, through the charge prophets Bmvassad , morality, as the
example and the example that emulate the human in the book of the Lord of the worlds and
their Prophet Lot, described the weak, and cheese, and lack of modesty, and disobedience ,
drinking alcohol , and his failure to raise his two daughters , Jews are corrupt in the ground .
Koran , which

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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
The dialectical relationship between the organization's growth and its value under the framework of the diversification strategy
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The research is conducted on target of investigating the role of growth strategy via diversification in value maximization of a firm in terms of controversies literatures had witnessed. Using a descriptive approach for analyzing and verifying the harmony of variables of research and their conceptualized logic , it could be reached to many conclusions agreed in their essence upon that the related diversification has the major role in value maximization of a firm and the wealth of its owners .                       

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
The Interactive Relationship between the Formation Elements and their Implications in the Structure of the Television Image
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The image of television dominates the cognitive and artistic motivations. It is the formulation of ideas and visions along with its documentary ability. It is the main element in television work as it is a story that is narrated in pictures. Therefore, attention to image building is a major point of gravity in the work structure as a whole. On the image is the element carrying all aesthetic and expressive values of news and information directly to the hints that work to stimulate and stir the imagination of the recipient to evoke mental images added to the visual images to deepen the meanings.
All visual arts carry elements and components that follow in a particular pattern to give special meanings and specific connotations. However,

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Publication Date
Tue Jul 04 2023
Journal Name
Qalaai Zanist Scientific Journal
The Role of The Environmental Observer and The Environmental Police in Protecting the Environment in Iraqi Law
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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
The Constant and the Variable in the Aesthetic Image of the Theatrical Direction: حازم عبد المجيد إسماعيل
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The theatre is one of the main pillars of the human aesthetic thinking as it contains logical explanations for the public human life aspects outside time and environment. When we find that the directive philosophical thinking moving away from the stylistic constants and the virtual laws in taboos that control the accomplishment in terms of the traditional shapes, the employment and the theatrical reception. Some directors moved in post-modernism concepts in a perceptive that liberates thought from its natural context in thinking into an innovative perceptive. The aesthetic images are the basic premise in the prohibition of the philosophical thinking interpretation in order to move the directive thinking and this movement depends on the v

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Investigating the Mastering of the Pronunciation of Weak and Strong Forms of English Function Words
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    The weak and strong forms are so called because it is not their lexical content that primary matter, but the role they have in the sentence. The problematic confusion, our students encounter, in recognizing and producing the correct pronunciation of weak and strong forms of the English function words is the main incentive behind conducting  this study. In order to gather the data, this paper used two types of tests: a recognition test and a production test. The general results reached  through the analysis of the students' answers seem to conform to the researcher's assumption: students face a critical problem in recognizing and producing correct pronunciation of the weak and strong forms of the English funct

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
The reality of interior design of Sharjah mosques and the possibility of development - selected models
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Observed mosques with the advent of Islam under the auspices of care being the houses of God Almighty, and I like parts of the ground to him, the center of radiation spiritual, intellectual and ideological in the lives of Muslims, was the most important cultural and architectural evidence built by Muslims voicing their deep faith and serenity Aqidthm.valmsadjad better reflecting the reality of communication between the person and his Lord, because he is the most important building of permanence and survival, making it imperative designed the best visual forms both externally and internally.Mosques have been characterized in the United Arab Emirates distinct characteristics in terms of building elements of construction in general, and the

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the Strategic Performance of the State Board of Antiquities and Heritage/Case Study
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This research aims to the possibility of evaluating the strategic performance of the State Board for Antiquities and Heritage (SBAH) using a balanced scorecard of four criteria (Financial, Customers, Internal Processes, and Learning and Growth). The main challenge was that the State Board use traditional evaluation in measuring employee performance, activities, and projects. Case study and field interviews methodology has been adopted in this research with a sample consisting of the Chairman of the State Board, 6 General Managers, and 7 Department Managers who are involved in evaluating the strategic performance and deciding the suitable answers on the checklists to analyze it according to the 7-points Likert scale. Data analysis re

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