Introduction. Intraoperative rupture (IOR) of an aneurysm is a frightful complication that causes significant morbidity and mortality worldwide. IOR can be attributed to various parameters, including hypertension, increased intracranial pressure (ICP), fragility of the vessels, and inadequate anaesthesia. IOR due to insufficient anaesthesia is scarcely reported in the literature. Here, we describe a re-ruptured anterior communicating artery (ACoA) after incomplete clipping of the neck during craniotomy closure due to unintended early wake-up from anaesthesia with a discussion about the management. Case description. A 38-year-old male suddenly developed a severe headache, a brief loss of consciousness, and vomiting. Computed tomography (CT) scan showed a subarachnoid haemorrhage in the basal cistern. CT angiography showed a bilobed right ACoA aneurysm with a wide neck and Murphy's teat. The patient was considered for surgery. Clipping of the aneurysm neck was done through two curved clips. During craniotomy closure, the patient started coughing and gagging then a huge IOR was encountered. These events can be mainly attributed to unintended inadequate anaesthesia, particularly muscle relaxants. The bleeding ceased after two suction catheters were inserted, temporary clips were applied, and the readjustment of permanent clips. After surgery, the patient showed a left-sided weakness. His postoperative CT scan showed a right distal anterior cerebral artery (ACA) territory infarction. The weakness improved in the follow-up period. Conclusion. Delayed IOR due to early awaking from anaesthesia should be considered a potential source of complications and bad outcomes in aneurysm surgery.
This paper aims to discuss and analyse the role and importance of implementing industrial Policy to promote industry and enhance economic development in developing countries. The paper discusses the economic justifications for using industrial policy as well as the criticisms leveled against it, for this purpose it analyses the ideas of two different approaches to industrial policy. The first held by the neo-liberals in the USA , who oppose the use of industrial policy and emphasise the role of the market in attaining economic development. The second, represented by many economists who support the use of industrial policy to promote industry and accelerate economic development, they justify their stand by pointing to the negative
... Show MoreThe research aims to develop the general performance and improve the level of activity of private insurance companies in line with the current progress of the country. Besides, Evaluating financial performance to diagnose weaknesses and strengths in sample research companies and then developing appropriate solutions. The deviation in the financial performance of the research sample was revealed by measuring the various accounts of the company. The research sample included five companies in the private insurance sector listed in the Iraqi Stock Exchange Market, which represent the private insurance sector. The research concluded that the added economic value is a broad concept that goes beyond the traditional performance evaluation process a
... Show MoreThe present research deals with the influencing factors which depends on the way perceptual of the graphic designer which enters in the design logos of the loco European health, where the search include four chapters, the researcher reviewed in the chapter 0ne the methodical frame of the research ,as reviewed in the second chapter the theoretical frame, and the previous studies which included three sections, the first section included the perceptual understandable and types of it, and the second section included the influencing factors in the designer perceptual ways and its division . While the third section included the perceptual in graphic designer through the percepted shapes and the relation with ground and colors for express the i
... Show MoreThis research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo
Effective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul
The issue of the public in the directions and theories of the theater director in the world theater, especially after the emergence of realism and the crystallization of the term direction and the definition of the role of the director in 1850 AD by the Duke Max Mengen took different paths to the Greek, Roman and even Elizabethan audience because it was here subjected to the theatrical equation from its production and presentation due to the fact that the theatrical performance is a technical artistic production, and the audience participation, watching and consumption, and here the participation of the audience was subjected to three directions: the enlightenment in the sense of arousing sense, the incitement in the se
... Show MoreAccording to grammarians In ( نإ) and Itha (اذإ) are conditionals and sometimes they may be used interchangeably. However, when they are mentioned in the Holy Qur’an, they have their own specific use. This paper attempts to investigate their meanings in the source language as well as investigate their translations and find out any differences or similarities. The translations that are adopted in this research are as follows: Pickthall, Al-Hilali & Khan, and Shakir.
The light-based life in the universe, including the human derived concepts and meanings of the fear of darkness and evil, comfort and goodness of light, became constitute bilateral haunted man to this day in various concepts of life.Therefore reflect the light form artistic aesthetic in visual arts such arts Fine Photography and the other until the emergence of art cinema, as the use of lighting in cinema has produced high-energy in the composition of its values expressive and symbolic, where it became dark and light are the space visually moving the vehicles media kit for many within the work structure artwork. The research is divided into five chapters, the first chapter (the methodological framework) that included an introduction the
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