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 Research Includes Two Variables : First , Academic Accreditation with his dimensions ( Educational Context , Educational Inputs , Educational Process , Educational Outputs , Feedback ) , And The Second : Strategic Performance With His dimensions ( Financing , Satisfaction Stakeholders , Internal Processes , Learning And Growth ) , The Research Highlights On The Academic Accreditation System Which Is Considered A Major And Important Systems Can Through Which Administration Of Activities And Programs Institutions Of Higher Education , As This research aims to determine his relationship And The Extent Of Its Effect In The Strategic Performance , And It Includes The Research C
... Show MoreCredit derivatives (CDs) have been increasingly acknowledged as an important requirement to hedge and transfer credit risk CR. Nonetheless, they have been extensively criticized for destabilizing the whole economic system bringing about the latest subprime credit crisis. The study’s main aim is to investigate the reason for the use of (CDs), whether it is used for hedging or trade purpose, for four of the US international financial institutions that had made it through the 2007 crisis to resume functioning post-crisis. This will be for three different and critical periods, namely the pre, during and after crisis periods (Q1, 2000-Q1, 2014). Adopting the SUR technique, the investigation of the factors that influence the net position of (CD
... Show MoreGravity and magnetic data are used to study the tectonic situation of Al-Kut- Al-
Hai and surrounding areas in central Iraq. The study included application of many
processing and interpretation programs. The window method with different spacing
was used to separate the residual from regional anomalies for gravity and magnetic
data. The Total Horizontal Derivative (THDR) techniques used to identify the fault
trends in the basement and sedimentary cover rocks depending upon gravity and
magnetic data. The identified faults in the study area show (NW-SE), (NE-SW) (NS)
and (E-W) trends. It is believed that these faults extending from the basement to
the upper most layer of the sedimentary cover rocks.
Aleppo bentonite was investigated to remove ciprofloxacin hydrochloride from aqueous solution. Batch adsorption experiments were conducted to study the several factors affecting the removal process, including contact time, pH of solution, bentonite dosage, ion strength, and temperature. The optimum contact time, pH of solution and bentonite dosage were determined to be 60 minutes, 6 and 0.15 g/50 ml, respectively. The bentonite efficiency in removing CIP decreased from 89.9% to 53.21% with increasing Ionic strength from 0 to 500mM, and it increased from 89% to 96.9% when the temperature increased from 298 to 318 K. Kinetic studies showed that the pseudo second-order model was the best in describing the adsorption sys
... Show MoreThe removal of commercial orange G dye from its aqueous solution by adsorption on tobacco leaves (TL) was studied in respect to different factor that affected the adsorption process. These factors including the tobacco leaves does, period of orange G adsorption, pH, and initial orange G dye concentration .Different types of isotherm models were used to describe the orange G dye adsorption onto the tobacco leaves. The experimental results were compared using Langmuir, and frundlich adsorption isotherm, the constants for these two isotherm models was determined. The results fitted frundlich model with value of correlation coefficient equal to (0.981). The capacity of adsorption for the orange G dye was carried out using various kinetic models
... Show MoreA field-pilot scale slow sand filter (SSF) was constructed at Al-Rustamiya Sewage Treatment Plant (STP) in Baghdad city to investigate the removal efficiency in terms of Biochemical Oxygen Demand (BOD5), Chemical oxygen demand (COD), Total Suspended Solids (TSS) and Chloride concentrations for achieving better secondary effluent quality from this treatment plant. The SSF was designed at a 0.2 m/h filtration rate with filter area 1 m2 and total filter depth of 2.3 m. A filter sand media 0.35 mm in size and 1 m depth was supported by 0.2 m layer of gravel of size 5 mm. The secondary effluent from Al-Rustamiya STP was used as the influent to the slow sand filter. The results showed that the removal of BOD5, COD, TSS, and Chloride were
... Show MoreThe subject of this study is one of the most interactive media networks, which is the Instagram.The study uses a descriptive approach and focuses on how Instagram turns from a media tool to a marketing tool. The study problematic consists of this question: How Instagram turns to a marketing tool, and what are the advantages and the disadvantages for that?This study highlights the definition of Instagram, the creation of it and its improvement, the Instagram in Bahrain, the Instagram uses, the Instagram as a marketing tool, and the advantages and disadvantages of using Instagram for marketing.The study confirms that Instagram is a new media network, and focuses on how it develops on later stages and mentions the increase of the percentage
... Show MoreCorona Virus Disease-2019 (COVID-19) is a novel virus belongs to the corona virus's family. It spreads very quickly and causes many deaths around the world. The early diagnosis of the disease can help in providing the proper therapy and saving the humans' life. However, it founded that the diagnosis of chest radiography can give an indicator of coronavirus. Thus, a Corner-based Weber Local Descriptor (CWLD) for COVID-19 diagnostics based on chest X-Ray image analysis is presented in this article. The histogram of Weber differential excitation and gradient orientation of the local regions surrounding points of interest are proposed to represent the patterns of the chest X-Ray image. Support Vector Machine (SVM) and Deep Belief Network (DBN)
... Show MoreZygnematales an order of green algae in Shaqlawa District Erbil, Kurdistan Region, Iraq, has been studied in eighteen sites, distributed between twelve springs and six along the streams within Shaqlawa district from September2019 to August2020. A total of 116 species belonging to 9 genera were identified. The most dominant genera included Spirogyra and Cosmarium (31, 30) taxa respectively. Out of them, 30 species were recorded for the first time in Iraq. Newly found genera included one species each for Cylindrocystis, Debarya, Hallasia and Staurastrum, nine species belonged to Mougeotia
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