Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a left pure posteriorly directed PCoA aneurysm. In the surgery, through the left pterional approach, all intraoperative steps were carried out. Additional steps were performed as well. Three additional intraoperative steps were contemplated because a pure posteriorly directed PCoA aneurysm is not well appreciated and is often hidden behind the supra cliniold internal carotid artery (ICA). First, the extension of Sylvian fissure dissection to include the distal part and the proximal. Second, temporal pole mobilization is performed by cutting small anterior temporal veins. Third, a brain retractor is placed on the temporal lobe to gently tract the superficial part of the lobe. All these steps widened the surgical corridor to ensure the aneurysm's safe clipping. Conclusion: Surgical clipping is influenced by the aneurysmal dome projection. In a ruptured pure posteriorly directed PCoA aneurysm, further intraoperative steps may facilitate complete access and safe clipping of the aneurysm.
Abstract
were determine the problem of current research to answer the question on the consciousness of the Ministry of Agriculture to adopt Staffing strategy and identify the shortcomings as the independent variable, represented by the three dimensions (recruitment , selection, placement) and its impact on high performance, as dependent variable is described in four dimensions (leadership, strategy, structure and processes, culture), in this research were Used analytical descriptive style . This research aims to identify the correlation and impact of Staffing strategy at high-performance in Ministry of Agriculture , To clarify the relationship between
... Show MoreResearch seeks to test the impact of the dimensions of mindfulness on organizational Innovation, proposed in the light of the review literature on two variables of the research, which referred in General to the dynamic relationship between them, as result of weakness of mindfulness as one important factor driving the diversity of innovation and time, ways to sustain and preserve and then support innovations made by creators, weakness in the overall level of organizational Innovation, this represents the problem research, data collection over designing identification, distributed to sample Formed from (30) head Department at a number of colleges of the University of Baghdad, results confirms the validity of resea
... Show MoreThe purpose of the research is to identify the social capital of the Municipality of Samawah Municipality by defining the level of its three dimensions (the structural dimension, the relational dimension and the cognitive dimension) and identifying the appropriate means that contribute to increasing the structural empowerment of the workers in the Municipality of Samawah. Between the social capital and the structural empowerment of the workers. From the perspective of social capital, the researchers examined the correlation and the effect of dimensions (structural, relational, cognitive) on the structural empowerment of the workers and with data collected from a sample of (168) Samawah, which is part of the Ministry of Constructi
... Show MoreThe research aims to show the role or extent of the impact of financing in its various forms on the municipal performance before and after the financial deficit through relying on the analytical research methodology of the research community represented by the Directorate General of Municipalities and the Directorate of Maysan municipalities as a sample of research (13) municipal institutions for a period of (8) years, Considering the completion of the final accounts of these years, which provides the necessary data for the study, in addition to the variation in the quality and amounts of grants allocated to municipal institutions during these years, which gives a clearer and more comprehensive picture of the reality of allocatio
... Show MoreThe technology and modern social communication medias have contributed to changing many of our concepts about education to a large extent; these technological advancements have created new challenges for the Instructor of course, but on the other hand it did provided him with expressive media, models and strategies that the old methods cannot fulfill, including the flipped classroom strategy, which is one of the modern technical solutions and in it's optimal use it can correct the weakness of the traditional education and can develop the communication skills as a whole among the students, in order to create a positive, active and interactive student.
The current research contained - four chapters: the first one included the methodolog
Abstract
The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin
... Show MoreThis research investigates the type and the significant relationship between roaming management and self-efficacy and its impact on excellence in providing hotel service. To achieve this, the applied approach was adopted through A questionnaire was designed and developed for the collected data. It has consisted of three parts. The firsts section included nine questions to measure the dimensions of management by roaming. The second section includes nine questions to measure the effectiveness of the two employees. The last section includes 12 questions to measure the excellence of the hotel service. The research sample included 43 employees' responding to this
... Show MoreOccupy public investment spending, a great deal of attention since the thirties of the last century, to play important role in economic and social development process and therefore most of the countries are trying different degree of economic development to the completion of the largest amount of public investment, especially in infrastructure, which is one of the pillars essential to economic development, and in order to maximize utilization of the completion of public investment should focus on achieving efficiency in completion.
The current reality of public projects in Iraq, indicating the absence of several key characteristics that must be provided if these proje