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.
Steel-concrete-steel (SCS) structural element solutions are rising due to their advantages over conventional reinforced concrete in terms of cost and strength. The impact of SCS sections with various core materials on the structural performance of composites has not yet been fully explored experimentally, and in this work, both slag and polypropylene fibers were incorporated in producing eco-friendly steel-concrete-steel composite sections. This study examined the ductility, ultimate strength, failure modes, and energy absorption capacities of steel-concrete-steel filled with eco-friendly concrete, enhanced by polypropylene fiber (PPF) to understand its impact on modern structural projects. Eco-friendly concrete was produced by the partial
... Show MoreExperimental measurements were done for characterizing current-voltage and power-voltage of two types of photovoltaic (PV) solar modules; monocrystalline silicon (mc-Si) and copper indium gallium di-selenide (CIGS). The conversion efficiency depends on many factors, such as irradiation and temperature. The assembling measures as a rule cause contrast in electrical boundaries, even in cells of a similar kind. Additionally, if the misfortunes because of cell associations in a module are considered, it is hard to track down two indistinguishable photovoltaic modules. This way, just the I-V, and P-V bends' trial estimation permit knowing the electrical boundaries of a photovoltaic gadget with accuracy. This measure
... Show MoreThis study expands the state of the art in studies that assess torsional retrofit of reinforced concrete (RC) multi-cell box girders with carbon fiber reinforced polymer (CFRP) strips. The torsional behavior of non-damaged and pre-damaged RC multi-cell box girder specimens externally retrofitted by CFRP strips was investigated through a series of laboratory experiments. It was found that retrofitting the pre-damaged specimens with CFRP strips increased the ultimate torsional capacity by more than 50% as compared to the un-damaged specimens subjected to equivalent retrofitting. This indicated that the retrofit has been less effective for the girder specimen that did not develop distortion beforehand as a result of pre-loading. From
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