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.
In this search, Ep/SiO2 at (3, 6, 9, 12 %) composites is prepared by hand Lay-up method, to measure the change in the thermal conductivity and Impact Strength of epoxy resin before and after immersion in H2SO4 Solution with a 0.3N for 10 days. The results before immersion decreases with the increase of the weight ratios of the reinforcement material (SiO2), It changed from (82.6×10-2 to 38.7×10-2 W/m.°C) with change weight ratios from (3 to 12) % respectively, but after immersion time in the chemical solution where it was (65.6×10-2 W/m.°C) at the weight ratios (6 %) and became (46.6 × 10-2 W/m.°C) after immersion in sulfuric acid. The results of the Impact strength decreased by increasing the percentage weight ratio, it changed f
... Show MoreThe research discusses two variables are important, orientation marketing and quality of service, and that the purpose of the research is to see whether the telecom companies applied orientation marketing or not and to what extent is keen to apply it to suit the Iraqi environment as it has been applied research in kork Telecom company and Asia Cell Telecom are sectors service job in the business sector in Iraq, The information was obtained through the design of the questionnaire compatible runway Likert, and distribution (92) questionnaire, which (50) for the company Korek Telecom and (42) of the Asia-Cell, research population sample included a number of staff in the departments and units in the two companies, it has been support
... Show MoreThe first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreThe external shocks are one of the phenomena that the Iraqi economy is exposed to over a period of time. It is referred to as changes and events that come from outside the economic system and extends to many economic variables. However, foreign direct investment may be severely affected due to the extreme sensitivity to changes and local and international developments. This type of trauma and its characteristics to help manage and cope with external shocks, and in order to avoid the standard problems experienced by some models of simple linear regression, multi-linear regression models were used with variables Scientific and other dummy variables .
The study foun
... Show MoreIn recent years, various methods have been developed to enhance the characteristics of asphalt pavement in order to face the continuous challenges of increasing traffic loads and changing climate conditions. One of the most popular and successful methods is modifying the asphalt mixtures or asphalt binder with the addition of polymers. Therefore, two types of Polyethylene (PE) polymer, High-Density PE (HDPE) and Low-Density PE (LDPE), are used in this research. Two methods were applied to prepare PE-modified asphalt mixtures: Semi-Wet Method (S-WM) and Dry Method (DM). The findings of the investigation indicated that the addition of PE polymer can reduce the wear loss of aggregate. In general, the experimental results revealed that asphalt
... Show MoreObjective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome
... Show MoreThe present study aims to reveal the extent of the influence of the acquired organizational immune through its dimensions (organizational vaccination, organizational learning, organizational memory, and benchmarking) in the application of knowledge management strategies in its two dimensions (codification strategy, personalization strategy) as well as clarifying that influential relationship between the study variables Because of its importance in reducing resistance to change by responding to the requirements of the environment. A set of main and sub-hypotheses emerged from the study, which was formulated in view of the hypothesis scheme of the study, and i
... Show Morethis research seeks to shed light on the study of the impact of Putinism on the Russian-Ukrainian war that broke out in early 2022, by studying the contents of the speeches of Russian President Vladimir Putin before the start of the war. This research uses the structural approach in analyzing the components of the Russian political regime. The research tools used in this research include case studies, content analysis of Russian speeches, and personal meetings of researchers and specialists in Russian affairs. It sums up a number of important conclusions, most notably are : 1) Putinism is a totalitarian regime that includes the political doctrine during the era of Russian President Vladimir Putin. 2) Duginism represents the totality of t
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