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 US invasion of Iraq in 2003 unleashed the repressed national aspirations of the Kurdish people. After the colonial powers, especially Britain, failed to establish a homeland of scattered Kurds in Iraq, Turkey, Syria and Iran, Iraq's Kurds managed to establish a semi-independent state in the north of the country Which lasted decades against the central authority in Baghdad in protest against what they call the forced integration of Kurds in the Iraqi state, and to obtain more rights and privileges as partners in this country. The federal region in the Kurdistan region of Iraq has become a reality, and it is eager not to strengthen its authority in return for the authority of the central government, but to annex other areas inhabited b
... Show MoreFrom a medical perspective, autoimmunity reflects the abnormal behaviour of a human being. This state is shaped when the defense of an organism betrays its own tissues. Allegedly, the immune system should protect the body against attacking cells. When an autoimmune disease attacks, it results in perilous actions like self-destruction. However, from a psychological perspective, the French philosopher Jacques Derrida (1930-2004) explains that autoimmunity harms both the self and the other. As a result, the organ disarms the betraying cells, as the immune system cannot provide necessary protection. From a literary perspective, Derrida has termed autoimmunity as deconstruction for almost forty years. Autoimmunity starts with the stage of a norm
... Show MoreAbstract:
The current research aims to distinguish the talent for the kindergarten
children and its relation with some changes . The research included ( 170 )
child (male , female ) from the kindergarten children on the year 2009 – 2010
the researcher had used PRED meter to achieve the goals of this research
after being sure from the honesty and the prove and the ( person ) connection
coefficient had been used to discover the relation between the talent and the
changes which had been mentioned in the research . The result proved that
the children had talents the toys and the educational scientifically scholarship
finally the researcher had presented some recommendations and suggestions
for other studies .<
This research deals with the concept of space in the theatrical performance and how the director works between two different spaces, the closed space and the open space. The question was how to use space according to the director's vision in the presentation. The problem of the research was whether the director of the Iraqi filmmaker could see the variable in the architectural space Or the place or space within the exhibition between open and closed, through the formation of the vision of the external components of intellectual and aesthetic and aesthetic, and impact on the relationship between the actor and the recipient to produce a new aesthetic space, and then the purpose of research and importance and limits and terminology The seco
... Show MoreFacing the Iraqi economy, a number of economic challenges that threaten the future of Iraq and the security of economic, political and social, such as poverty, unemployment, inflation and the dilapidated infrastructure and rising production costs and administrative and financial corruption, environmental pollution, water problems and the deterioration of agricultural and industrial production, etc., and over the seriousness of these challenges, they are intertwined and overlapping and growing worse, without the corresponding adoption of state strategies that will develop appropriate solutions and appropriate to resolve those challenges because of concern the subject of security and terrorism, which requires the development of an
... Show MoreThe aim of this research is to clarify the importance of total quality management. Total quality management considered as a cultural process covering the various aspects of activities in society that helps human well-being, as well as the development of its efficiency and ability. They also have an effective role in achieving the desired goals that will benefit humanity. The concept of total quality management in the Qur'an is a broad, comprehensive and well integrated concept that aims to improve human life economically and socially. Quality in the Qur'an is a mean to achieve human beings happiness.
In this research we will highlight a successful story of quality management from Qur'an that ensures consumer protection and support of
This paper is attempt to study the nonlinear second order delay multi-value problems. We want to say that the properties of such kind of problems are the same as the properties of those with out delay just more technically involved. Our results discuss several known properties, introduce some notations and definitions. We also give an approximate solution to the coined problems using the Galerkin's method.