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.
Research Summary
This research is an attempt to explain the Qur’anic verses of the vision in the practical divine vision on the Day of Resurrection, and the legal texts narrated from the Companions regarding the vision of the Prophet, may God’s prayers and peace be upon him, regarding the vision of the Prophet, may God bless him and grant him peace, regarding the vision of the Prophet, may God’s prayers and peace be upon him, regarding the vision of the Prophet, may God bless him and grant him peace He was greeted with regard to vision, and he explained the two sayings of Ibn Abbas and Aisha on the same subject, including an area of conflict between them.
The research aims to identify small and medium enterprises in accounting thought in terms of definition and concept, and this international financial reporting standard for small and medium-sized enterprises (SMEs) in the theoretical aspect. As for the practical aspect, the small and medium-sized enterprises standard has been applied to the financial statements of the company in question, the preparation of the opening entry on the date of the transition, the requirements of measurement and the accounting disclosure on the date following the application of the standard, and the preparation of the company's financial statements and the accompanying explanations according to the standard of small and medium-sized enterprises. The r
... Show MoreBackground: Orthodontic mini-implants are increasingly used in orthodontics and the bone density is a very important factor in stabilization and success of mini-implant. The aim of this study was to observe the relationship among maximum bite force (MBF); body mass index (BMI); face width, height and type; and bone density in an attempt to predict bone density from these variables to eliminate the need for CT scan which have a highly hazard on patient. Materials and Methods: Computed tomographic (CT) images were obtained for 70 patients (24 males and 46 females) with age range 18-30 years. The maxillary and mandibular buccal cortical and cancellous bone densities were measured between 2nd premolar and 1st molar at two levels from the alveol
... Show MoreThe Islamic architectural heritage constitutes a civilized fortune that has to be preserved and protected and work should be done to maintain its development to be more convenient for the circumstances of the age and the civilization transformations. Due to the fact that architecture represents the civilization pot and cultural identity, its originality has to be preserved and work has to be done to prevent the strange architectural invasion that changes its character and make it lose the identity and the character and detached from its roots and environment.
Decoration, in the interior design, as a concept is connected to ornamentation process of interior spaces, which is a process of adding certain items
... Show MoreMammals are under threat worldwide due to deforestation, hunting, and other human activities. In Iraq, a total of 93 species of wild mammals have been recorded including species with global conservation concern. Bamo Mountain is situated within the Zagros Mountains in northern Iraq which is a suitable habitat for wild mammals. Due to scarcity of the field survey efforts and cryptic behavior, monitoring of the wild mammals fauna in Zagros Mountain seems challenging. Therefore, we used a camera trap which seems to be an ideal way to determine species diversity of wild mammals in Bamo Mountain. Moreover, interviews with local villagers were performed. The mammalian diversity of Bamo Mountain is not fully explored but seemed threatened by lo
... Show MoreAbstract
The aim of the current research is to prepare an integrated learning program based on mathematics standards for the next generation of the NYS and to investigate its impact on the development of the teaching performance of middle school mathematics teachers and the future thinking skills of their students. To achieve the objectives of the research, the researcher prepared a list of mathematics standards for the next generation, which were derived from a list of standards. He also prepared a list of the teaching competencies required for middle school mathematics teachers in light of the list of standards, as well as clarified the foundations of the training program and its objectives and the mathematical
... Show MoreObjectives: To assess levels of premenstrual psychological disorders of the students in Bab Al-Mua’dham Complex and to find out the relationship between the levels of premenstrual psychological and physical disorders and some demographic characteristics of the students. Methodology: A descriptive study was accomplished throughout the period from the 1st of October, 2015 to the 8th of July, 2016 to assess the psychological and physical problems. A purposive sample of 313 students distributed among different colleges of Bab Al-Mua’dam complex distributed as following: 82 students are from college of Arts; 79
Objectives: To assess levels of premenstrual psychological disorders of the students in Bab Al-Mua’dham Complex and to find out the relationship between the levels of premenstrual psychological and physical disorders and some demographic characteristics of the students. Methodology: A descriptive study was accomplished throughout the period from the 1st of October, 2015 to the 8th of July, 2016 to assess the psychological and physical problems. A purposive sample of 313 students distributed among different colleges of Bab Al-Mua’dam complex distributed as following: 82 students are from college of Arts; 79 students are from College of Languages; 48 students are from college of Islamic Sciences: and 104 are from College of Nursing. For t
... Show MoreThe splicing design of the existing road and the new road in the expansion project is an important part of the design work. Based on the analysis of the characteristics and the load effect of pavement structure on splicing, this paper points out that tensile crack or shear failure may occur at the splicing under the repeated action of the traffic load on the new/old pavement. According to the current structure design code of asphalt pavement in China, it is proposed that the horizontal tensile stress at the bottom of the splicing layer and the vertical shear stress at other layers of the splicing line should be controlled by adjusting the position and size of the excavated steps in addition to the conventional design ind
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