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.
Abstract
The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
... Show MoreLinguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th
Since the invention of the automobile, no aspect of American life, including crime and its control, has remained untouched by this far-reaching innovation in transportation. Vehicular "hot pursuit"-when suspects in motor vehicles use excessive speed in attempting to elude the police. Unfortunately, accounts of wild chases across crowded inner city streets, through tree-lined suburban boulevards, and over remote country roads are very real and not merely fictional material created for entertaining television and motion picture audiences. The specter of "hot pursuit," complete with screaming sirens and red or blue flashing lights, has become a recurring fact of modem life.1 So, too, are the mishaps involving police vehicles or the vehicles pu
... Show MoreAn annotated list based both on personal collections and on literature records, is presented for twenty species and subspecies of Chrysomelinae from Iraq. Eight of which are newly recorded, bringing the total number of species and subspecies for Iraq to 25. Localities and host data are given for most species.
This study aims at investigating the partial Islamic rules of preparing and distributing cartoons in order to issue an overall Islamic rul. To reach an end, descriptive and analytical approaches are adopted to clarify the nature of cartoons and other related concepts. The researcher, as well, with reference to verses of the Holy Quran, tradition (Hadith) and Islamic jurists, adopts a deductive approach to issue Islamic rules related to the industry of cartoons and it's distribution
The study consists of three sections. The first Section addresses the following issues: Definition animation; and related wordy. The second Section: Origin of Cartoon's history and it's negative and positive effects. The third Section: Islamic rules related
This paper is intended to focus on the existing relation between 'logic' and 'meaning', and how 'meaning' is looked at through logical perspective. Besides, this paper adopts simple logical symbols to represent some aspects of meaning.
Since meaning is still regarded as a thorny area that needs further study to determine its nature and borderline, this paper proposes to resort to logic and logical rules. This paper points out how logical rules are used and how they clarify some oblique sentences. The paper also sheds light on how meaningful sentences are logically symbolized and how logic can define the borderline of meaning in an adequate manner. This paper hypothesizes that logic, l
... Show MoreMotives for public exposure to specialized sports satellite channels and the gratifications achieved about it - Research presented by (Dr. Dr. Laila Ali Jumaa), Imam Al-Kadhim College (peace be upon him) - Department of Information-2021.
The research aims to know the extent of public exposure to specialized sports satellite channels, and what gratifications are achieved from them, and to reach scientific results that give an accurate description of exposure, motives and gratifications verified by that exposure, and the research objectives are summarized in the following:
- Revealing the habits and patterns of public exposure to specialized sports satelli
Besides the role of state institutions that come in the forefront of their priorities and obligations to provide security and development of the economy and reduce the unemployment rate and the reduction of inflation and improving education, health and others, the Community Partnership At frames what has become known as the institutions of society civil-with the state does not eliminate the role, but rather complements its role ; it is the role of civil society partner and an extension of the role of the state in the face of challenges and crises, but it may be sometimes a race role in addressing social, political and economic issues of the role played by the state, not complementary.
The highlighting the specificity of the relationsh
The research aims to shed light on the nature of the tax gap in the income tax by the method of direct deduction and its reflection on the financial objective of the tax, and to determine the reasons for this gap in the deduction between the tax due in accordance with the laws and instructions in force and the tax actually paid. The tax gap is a real problem that cannot be ignored for what it represents loss of financial revenues due to the state.
The research problem is represented in the existence of a gap between the tax due according to direct deduction instructions and the tax actually paid according to the financial statements, and to achieve the objectives of the research and test the hypotheses, t
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