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.
Abstract:
The achievement of economic and social welfare for individual is the main target to all policies that adopted by all countries worldwide either were economic, social, political or others. The obtaining of education by individuals and especially the higher education is one of the most important determinates in achieving the wellbeing and lasted economic development. This is because via the higher education new fields can be opened in front of individuals in order to get adequate jobs associated with their scientific specialization. This is allowing educated individuals gain higher income that can reduce the gap of income inequality.
Thus, this paper aims to analysis the n
... Show MoreThe solution to the problems and challenges of the twenty-first century requires the absorption of many transformations, such as demographic change, poverty reduction, the expansion of safe and clean energy without affecting the environment, as well as reducing health risks and other transitions. It also requires greater cooperation than is possible in the current global system, because both of these constraints and challenges, even if addressed locally or nationally, are because of the potential for their transnational impact, that is, their impact on the lives of people at the global level, Which is necessary to be fully addressed unless it is guided by a comprehensive global vision. This is what environmental governance provides in te
... Show Moreخلاصة (استطاعت اليابان بعد الحرب العالمية الثانية ان تنهض من جديد، وان تحقق تجربة تحديث سياسي جعلها تشهد تبدلات جذرية من الفقر الى الغنى ومن سيطرة الحكم العسكري الى الدولة المنزوعة السلاح ومن التخلف الى التكنولوجيا الاكثر تطورا في العالم, ومن الانغلاق والعزلة وذهنية سكان الجزر الى الانفتاح على ثقافات عصر العولمة ووسائل اعلامها. فكيف يمكن الاستفادة من هذه التجربة الحديثة سياسيا بل وحتى اقت
... Show MoreAllah the Almighty has honored many of his slaves in the high houses for their efforts in building the scientific edifice of this nation, by demonstrating what is needed from the legal provisions for all the relations between them, and the actions that they emanate from. The tasks of the abbreviations and Almstsot, and deposited in the mabahith after various investigations and precious precious matters and showed all the human needs in his life and what is expected to happen, even on the rarest possibilities, and their efforts that left the nation on the cases of Goliath. , And Ask They are in Dar dignity with the best creatures and make us a share of those good things, and Odamna to obey Him and His pleasure until death, and forgive us
... Show MoreAdult of dipterous flies were collected monthly from exposed animals carcasses during the period from February 2006 to January 2007 in Baghdad city. The results obtained showed that flies could be collected all over the year with variation of their population density in different seasons. The majority of the collected species were abundant during Spring and late Autumn (at lowest numbers) . In this investigation, nineteen species confined to four families were collected; these families are: Calliphoridae, Muscidae, Sarcophagidae and Fanniidae. The species Musca domestica Linn .was the most abundant followed by Chrysomya megacephala ( Fabricius ) , while Pollenia sp . and Fannia sp . were the least abundant species.
The study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the mo
... Show MoreThis research is an attempt to unveil the cover and unveil a matter that has become mysterious to those who came after Sibweh of the grammar scholars; It took place as a result of the work of the scribes.
In this paper, wavelets were used to study the multivariate fractional Brownian motion through the deviations of the random process to find an efficient estimation of Hurst exponent. The results of simulations experiments were shown that the performance of the proposed estimator was efficient. The estimation process was made by taking advantage of the detail coefficients stationarity from the wavelet transform, as the variance of this coefficient showed the power-low behavior. We use two wavelet filters (Haar and db5) to manage minimizing the mean square error of the model.
بعد ثورة تموز عام 1958في العراق, لم يكن يسمح للقطاع الخاص بأن تكون له استثمارات كبيرة في القطاعات الاقتصادية. وذلك بسبب الإيديولوجيات التي كانت تؤطر الفكر السياسي. حيث كان النهج الاشتراكي هو الغالب في إدارة الأنشطة الاقتصادية. إذ قامت الدولة بتأميم معظم الاستثمارات الخاصة الكبيرة ،لاس
... Show MoreIn this study, mesoporous silica (MPS) is made using the sol-gel method from a cheap source (Na2SiO3) using the surfactant hydroxycetyl hydroxyethyl dimonium chloride as a template. The task is the adsorption-based removal of the medication metoprolol (MP) at concentrations between 10 and 50 ppm. Variables such as: contact time, dose of adsorbent, starting concentration of adsorbate, and adsorption temperature were studied which show the equilibrium time and adsorbent dose are 40 min and 0.05 g respectively. The Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich isotherm models were fitted to the data obtained from the experiments. Comparing the outcomes showed that, of the four investigated isotherm models, the Freundlich equation m
... Show More