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 paper aims to build a model that supports organizational sustainability by analyzing the correlations and revealing the impact between the two main variables (entrepreneurial leadership) with its dimensions of proactive outlook, risk, and creativity (Van Zyl & Mathur-Helm, 2007), and (organizational sustainability) with its economic, environmental, and societal dimensions (Hansmann et al., 2012). As well as identifying the level of awareness and informing managers in the General Company for the Automotive and Equipment Industry, of the theoretical implications and performance, and its vital importance to society and the surrounding ecological environment, and drawing attention to that and improving performance, and indicatin
... Show MorePraise be to Allah. Praise be to Him. We seek refuge in Him. We seek forgiveness from him. We seek forgiveness from him.
And the disadvantages of our actions, of his hands
e
It is important, if not all, to pay tribute to God
Muhammad Abdo and Rasoulou, there is no way to deprive the nation of the weakness of God alone and not to share it
Which suffer from the Quran, and the loss of its borders, bad
The work did not work and did not improve
Do what they offer and delay the others, except by reference to this Koran and the extraction of treasures and secrets
And news.
The Great Quran Study
Lu Imito ordered each poisoned, and achieved several targets of
YEMYA: Knowing the secrets of the Grea
Globally, iron deficiency anemia is a problematic nutritional deficiency health-related issue that impacts early-adulthood people such as university students. The aim was to asses female nursing students’ knowledge concerning iron deficiency anemia in the College of Nursing, University of Baghdad.
A cross-sectional survey was carried out from the period of June 18, 2023 to December 20, 2023. Nonprobability (purposive) samples of 100 female nursing students were selected from the second, third, and fourth stages in the College of N
Sustainable human development means meeting the basic needs of society and striving for continuous improvement in quality, as it seeks to increase economic well-being while providing adequate housing and nutrition, as well as providing electricity, water, health and education services . Ten centuries ago, Islam highlighted the importance of the development effort and the necessity of its sustainability before the West took it in the 1970s. There are a number of challenges that greatly affect the reality of achieving and ensuring Millennium Development Goals. The research recommends the importance of fighting administrative and financial corruption, as this is one of the biggest challenges facing the possibility of advancing the economy and
... Show MoreThis paper deals with the ideological positioning of the English poet John Donne in a selected poems of his i.e Holy Sonnet X, as regards the theme of death found therein. The researchers adopt an emerging branch of stylistics, called Critical Stylistics, as proposed by Jeffries (2010) in order to uncover the ideologies of the author regarding the topic concerned and how linguistic choices are used to slant ideas. The model is comprised of ten tools of analysis which, upon being applied to the selected data, have shown how the poet exploits language resources in order to pass his ideology and influence his readers. In this paper, the workings of only one tool are presented as applied to a certain portion of the data.
The current specialized research tagged (intellectual and artistic concepts of the cultural context and their impact on contemporary ceramic sculpture) paves the way for the emergence of the context in ceramics active in life, so that this relationship will indicate the development and presence of ceramics or not and the volume of its circulation in the joints of the culture of the Arab recipient. As a result, the researcher collected scientific materials to serve the subject of the research in four chapters: Chapter One (General Methodological Framework) To clarify the problem of the research, the importance of the research to achieve benefit in higher education and education for scholars and teachers, while the research aims to revea
... Show MoreThe goal of this work is to check the presence of PNS (photon number splitting) attack in quantum cryptography system based on BB84 protocol, and to get a maximum secure key length as possible. This was achieved by randomly interleaving decoy states with mean photon numbers of 5.38, 1.588 and 0.48 between the signal states with mean photon numbers of 2.69, 0.794 and 0.24. The average length for a secure key obtained from our system discarding the cases with Eavesdropping was equal to 125 with 20 % decoy states and 82 with 50% decoy states for mean photon number of 0.794 for signal states and 1.588 for decoy states.