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.
Because of the tremendous changes in the business environment and significant growth in living standards, increased demand for services in general and about the realized practitioners in the field of service that traditional marketing strategies and models administrative based solutions to mono as the price alone does not lead to the desired outcomes with customers and even organizations as it does not apply always for the manufacture of their services unique . therefore , the need to learn marketing service order and a clear and critical to avoid failures in service and the marketing document to knowledge would avoid the organization that the failure in the delivery of service and enhances the desired response to fix it in a tim
... Show MoreThe study of an urban street scene of the life cycle is one of the important things in urban scene studies and there are four vocabularys that are the basis for the life cycle of an urban scene and these vocabulary are (the street, transformation, land uses and urban scene).
the first vocabulary addressed in the research is the street where street classes were studied and its classifications in terms of morphology and function and study of street standards in cities.
The second term, are transformations, where the concept of transformation and its patterns and
... Show MoreAdvertisement is one of the Media most efficient persuasive communicative activities designed to marketing different ideas and products with the aim of influencing consumers' perception of goods and services. The present study sheds light on the most prominent rhetorical devices that constitute the persuasive structure of the Hebrew advertisements published in various media outlet. The study is conducted by means of analyzing the linguistic structure of the advertising texts and according to the analytic and descriptive approach to know the characteristics and the functions of the oratorical devices used in the advertising industry. The research elucidates that most of the advertisements are written in slang language, and this is due to th
... Show MoreThe first known use of the term conspiracy theory dated back to the nineteenth century. It is defined as a theory that explains an event or set of circumstances as the result of a secret plot by usually powerful conspirators. It is commonly used, but by no means limited to, extreme political groups. Since the emergence of COVID-19 as a global pandemic in December 2019, the conspiracy theory was present at all stages of the pandemic.
The first known use of the term conspiracy theory dated back to the nineteenth century. It is defined as a theory that explains an event or set of circumstances as the result of a secret plot by usually powerful conspirators. It is commonly used, but by no means limited to, extreme political groups. Since the emergence of COVID-19 as a global pandemic in December 2019, the conspiracy theory was present at all stages of the pandemic.
The name of God the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the prophets and messengers Prophet Muhammad and his family
And his companions who followed his approach to the Day of Judgment. After that, Islam has paid great attention to the aspects of education
The promise of a way to degrade and correct behavior, and to reach the individual to the highest levels through his intellectual upbringing
Mentally, mentally, mentally and intellectually, education at all times and places is the best way to communicate to a human being
The degree of happiness in religion and the other, as it develops all aspects of his personality, and supports the love of goodness for himself
For people, edu
The person who wants to learn. The history of Bab’is will notice a very
starnge phenomenon that they (Babis and Baha’is) resort to visions to prove their
delusion.
The believers usually reach to each other by their visions. This phenomenon
are shared among them from Al- Ahsa’ai time till the last phase of their propaganda
which is the Baha’is propaganda, and this is due to their ignorance and under
development in doctrine of islam which was widespread in Iran and the Islamic world.
The whole secrets of Babis and Baha’is movement were restricted among
particular group, most of them were Al- Rashti’s students and knew the basic
principles of their movement which deperding or (the principles) declarati
This paper is mainly concerned with the study of the moral aspects that prompts William Shakespeare to attempt a romance in which he has embedded the epitome of his thought, experience, and philosophy concerning certain significant aspects of human life whose absence or negligence may threaten human existence, peace, and stability. From the beginning of history man realizes the importance of prosperity on the many and various levels that touch and address his needs and desires—natural, material, and spiritual. The Tempest, due to the dramatist's awareness of the aforementioned values, reflects the dramatist's duty as to projecting and unfolding these important aspects, rec
... Show MoreThe Iraqi- Kuwaiti relations had witnessed a lot of problems which had its impact on them, at the fore front is the frontier issue, and the Iraqi invasion of Kuwait in 1990 which led to the severance of relations between them and had strengthened the disagreement and the dispute and raised the animosity and tension.
After 2003, Iraq has witnessed a lot of changes which affected Iraq and the region as a whole.
Under the new political developments in Iraq, a now phase has started in the relations between the two parts. which is based on the emphasis on building new relations based on the mutual respect and non intervention in the internal affairs of both countries, and in accordance with the principles of the international law, and w