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.
The media guide is a small-sized printed medium, whose importance is highlighted through the specific information it carriesThe task of the guide lies in the clarity of these indications and making a positive impact on the recipient with understanding so it is a means for the purpose of reaching the effect and effectiveness of the message symbols from the movements of lines in which elements that are supposed to be equal in the performance of their functions and the purpose of their existence gather to achieve the mental response of perception, understanding and enjoyment. It must be in an objective unity based on the balance in this distribution. To form a formal organizational unit and an integrated system, the result of which is to gi
... Show MoreNeuro-ophthalmology, bridging neurology and ophthalmology, highlights the nervous system’s crucial role in vision, encompassing afferent and efferent pathways. The evolution of this field has emphasized the importance of neuroanatomy for precise surgical interventions, presenting educational challenges in blending complex anatomical knowledge with surgical skills. This review examines the interplay between neuroanatomy and surgical practices in neuro-ophthalmology, aiming to identify educational gaps and suggest improvements.
A literature search across databases such as PubMed, Scopus, and W
Amongst the literary writers who used their art to direct the attention towards the issue of woman and her rights in a proper life is the English poet and novelist Thomas Hardy (1840-1928), who has been praised for his “openness to the feminine principle” 1 as Irving Howe put it. Hardy’s wide readings have changed his way of dealing with and thinking about so many critical issues which started to float on the surface of the English society during the mid and late of the 19th century. His readings for a number of writers, who seem of huge impact on his writings as he later admits that – “[his] pages show harmony of view with
... Show MoreBackground: The surgical treatment of pilonidal sinus varies from wide excision and laying the wound open or excision with primary closure or excision with the use of skin graft in some special cases.
Objectives: The objectives of this study is to determine the efficacy of treating non complicated pilonidal sinus disease with minimal excision and primary closure technique, complications and recurrence rate.
Patients and methods: This is a prospective study conducted in shahid ahmed ismaiel hospital in rania – As sulaimania IRAQ during the period from December 2013 to January 2016 and was carried on one hundred (100) consecutive patients with non complicated non recurrent pilonidal sinus patients who were treated with minimal exci
There are no words in the universe that are collected, communicated, raised, and greater than the words of God, Lord of the worlds, and there is no guidance except with Him, nor guidance except with His guidance, and no knowledge except with Him, and how is he guided by the lost without guidance from God Almighty !?
In this research, I tried to address what collects hearts, composes souls, and spreads love among members of society as part of the social twinning and good coexistence between people. Harmony, love, and the roots of fragmentation, fighting and feuding.
This verse is blessed and I chose {Taking the Charter of the of Israel do
... Show MoreIn the era of the digital economy, public organizations need to consolidation the capabilities of entrepreneurial alertness to reduce the risks of sudden transformations and changes, and to find effective mechanisms to discover and invest in environmental opportunities proactively, as this concern has become a knowledge gap in public sector institutions, the current research aims to identify the role of digital competence in influencing on entrepreneurial alertness in the Central Bank of Iraq (CBI), the descriptive analytical approach was used as a research method to describe and analyze the main research variables. digital competence as an explanatory variable includes three dimensions: digital infrastructure, digital integration, and d
... Show MoreBackground: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te
The present study designed to determine the ethanolic extract of Cyperus rotundus on Liver in Albino Male Mice . In the present study 18 Male mice were used they divided into six groups ( 1st group consedered control group , 2nd group injected by 250 mg/ml from extract , 3th group injected by 300 mg/ml from extract , 4th group injected by 350 mg/ml from extract , 5th group injected by 400 mg/ml from extract and the 6th group injected by 450 mg/ml from extract ) . the expermint lasted for two days and the doses gived by intraperitonial injection . showed from the study results that ethanolic extract for Cyperus rotundus have negative effect on Liver tissue in 250 , 300 , 350 mg/ml concentrations when comparsion with control group . the re
... Show MoreThis paper presents the synthesis and study of some new mixed-liagnd complexes containing tow amino acids[Alanine(Ala) and phenylalanine (phe)] with some metals . The results products were found to be solid crystalline complexes which have been characterized by using (FT-IR,UV-Vis) spectra , melting point, elemental analysis (C.H.N) , molar conductivity and solubilty The proposed structure of the complexes using program , chem office 3D(2000) . The general formula have been given for the prepared complexes : [M(A-H)(phe-H)] M(II): Hg , Mn ,Co , Ni , Cu ) , Zn , Cd(II) . Ala = Alanine acid = C3H7NO2 Phe = phenylalanine = C9H11NO2