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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
Sat Nov 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the tax gap resulting from the application of the direct deduction method and its reflection on the financial objective of the tax: Applied research in the General Directorate of education in Diyala
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The research aims to shed light on the nature of the tax gap in the income tax by the method of direct deduction and its reflection on the financial objective of the tax, and to determine the reasons for this gap in the deduction between the tax due in accordance with the laws and instructions in force and the tax actually paid. The tax gap is a real problem that cannot be ignored for what it represents loss of financial revenues due to the state.

The research problem is represented in the existence of a gap between the tax due according to direct deduction instructions and the tax actually paid according to the financial statements, and to achieve the objectives of the research and test the hypotheses, t

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluating the extent of the response of the tax administration leaders towards the concept of the strategic lens and its relationship to tax pioneer performance: Applied Research in the General Authority for taxes
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The aim of the research is to evaluate the response of the researched leaders towards practicing the concept of the lens, which is its dimensions with (stakeholders, resource mobilization, knowledge development, culture management) and the nature of its relationship to tax pioneer performance represented in its dimensions (strategic direction, leadership indicators, growth, renewal and modernization, efficiency, Effectiveness) The questionnaire was approved as a main tool in collecting data and information from the sample members in the General Authority of Taxes, which number (91) Who are on (M. General Manager, Division Director, Deputy Director, Senior Division Director, Deputy Director, Second Division, Division Officer, M. D

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Publication Date
Tue Sep 01 2020
Journal Name
Baghdad Science Journal
Preparation of Polymeric Composites from Polypropylene and Palm Fronds and the Study of Some of Their Physical Properties
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Abstract:
              In this study a type of polymeric composites from melting poly propylene as a basic substance with Palm fronds powder were prepared. Evaluation of polymeric composites was done by studying some of it is mechanical properties, which included:Yong modulus (E), Impact Strength (I.S), Brinell hardness (B.H) and Compression Strength (C.S). The polymeric composites were studied before and after reinforcment by comparing between them. There was an increase in resistance of Yong modulus (E), Impact Strength (I.S), Brinell hardness (B.H) and compression Strength (C.S). Also, the effect of some acids were studied such as (HCl, H2

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Publication Date
Sun Jan 05 2020
Journal Name
Annals Of Tropical Medicine And Public Health
[CITATION] Direct and deferred retrieval of basketball for student of the college of physical education and sport sciences
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Publication Date
Thu Mar 14 2013
Journal Name
Journal Of Kerbala University 11 (3)‏
Effect of chemical fertilization and gibberellic acid on the contentofsomechemical compounds of Nepali and Khudairi cultivars of olive‏
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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The relationship between the external environment analysis and banking facilities: An Applied Research in the Rafidain and Rasheed Bank
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Is the subject of environmental analysis of the important issues that should occupy the attention of the departments of banks in general and banks in particular, the research sample, regardless of their size and the nature of its activity, So if the current era and witnessing rapid developments and changes, making the banking environment is more complex and interconnected than ever, And it became not possible for banks to be aware and understand the external environment variables without an analysis of the various constituent elements and influential heavily in its financial and administrative,Therefore research aims to find out the relationship between the external environment and banking facilities analysis application on the Rafidain

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Publication Date
Sat Apr 01 2017
Journal Name
Ieee Transactions On Microwave Theory And Techniques
A Millimeter-Wave Gyroelectric Waveguide Isolator
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Publication Date
Thu Dec 01 2016
Journal Name
2016 Asia-pacific Microwave Conference (apmc)
A Q-band gyroelectric waveguide isolator
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Publication Date
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
Arrhythmia-Induced Cardiomyopathy. A Palestinian Experience
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A 20 year-old male was admitted with a history of recurrent palpitations from 5 years. Baseline ECG revealed premature ventricular contractions (PVCs) with delta waves. Stress ECG showed short non-sustained Ventricular tachycardia (VT). Echocardiography showed moderate dilation of the left ventricle with mild reduced systolic function and Ejection fraction was estimated to be 42%. Right ventricle was mildly dilated and hypokinetic. Both atria were mildly dilated. The patient referred to CVC for EP study with possible ablation. The ablation of the focus led to complete suppression of the ectopy. Post-procedure ECG and echocardiography showed normalized rhythm and systolic function.

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Publication Date
Sat Jun 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Gas Holdup in a Bubble Column
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