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.
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This research sheds light on the major sins (fornication and sodomy) as two crimes that are prohibited by the divine laws, including its conclusion by the Islamic Sharia. Major sins so that life and the universe are organized, and the individual lives a life of chastity and purity free of filth and filth. The Islamic message included a set of preventive measures and remedial methods that, if the ummah were to apply them, they would live a decent life full of noble goals.
Abstract
This study aims to identify the repercussions of the Corona pandemic (Covid 19) and its impact on the educational and psychological functions of the Omani family from the point of view of a number of fathers and mothers. Drive for a group of fathers and mothers, some of whom work in the government sector and others are mothers enrolled in graduate studies programs at the university, their ages range between (30-50 years) totally (28) mothers and fathers: 22 mothers and 6 fathers. The results showed that the repercussions of the transformation of e-learning, home quarantine, social distancing, and the challenges associated with them were among the most frequent responses that posed a real challenge to the
... Show Moreتعد المحاسبة بشكل عام علماً لكنها ليست من العلوم الصرفة وإنما من العلوم الإجتماعية مما يتطلب للتعامل مع المواضيع المحاسبية الأخذ بنظر الاعتبار الأشخاص المعنيين بالموضوع سواء كانوا المعدين للمخرجات المحاسبية أي المحاسبين، أو الاطراف ذوي المصالح المعنيين والمستفيدين من هذه المخرجات أي المستخدمين، ويعد المحاسب جزءاً من العملية الاجرائية نفسها وبهذا يكون دوره مزدوجاً يجمع بين كونه القائم بالبحث والقي
... Show MoreSoft red winter wheat (SRW) is characterized by high yield and relatively low protein content. In Kentucky, there is growing demand from local artisan bread bakers for regionally produced flour, requiring production of grain with increased protein content and/or strength. The objective of this two-year field experiment was to evaluate the effect of nitrogen (N) management on five cultivars of winter wheat on yield and bread baking quality traits of modern and landrace SRW cultivars (Triticum aestivum L.). All five cultivars were evaluated using two N application rates in conventional and organic production systems. All traits measured were significantly affected by the agricultural production system and N rate, although plant height
... Show MoreThe impact of applying the K-W-L self-scheduling technique on first-year intermediate students' learning of basic volleyball skills, Ayad Ali Hussein*, Israa Fouad Salih
The research dealt with the impact of reinsurance on the financial surplus of the National Insurance Company by focusing on reinsurance in the marine insurance / merchandise branch. The aim of this research was to show the impact of reinsurance indicators (reinsurance ratios, retention ratios, commission rates earned) on reinsurance operations Data on the research variables were collected based on the inductive and deductive approach in the analysis of information for the financial reports of the National Insurance Company of the Marine Insurance Branch and the insurance portfolio (goods) for the period from 2010 to 2017, and for the purpose of obtaining results was used M a number of statistical methods commensurate with the nature of t
... Show MoreYou Mohammed, you're prophet of God and I'm Gabriel)). With this heavenly call which Mohammed, the messenger of God (may God's mercies be on him), got and when he left Hiraa cave and after getting the aye ((read with your God's name)), a new period of mankind's history started. From that time, the greatest state was established. There was no public treasury and no public financial resources at that time. Abu Baker (God bless him) spent a lot of money to support the costs of the new mission. After Al-Hijra, the bases of establishing the Islamic state were available but it lacked administrative and financial organizing. Therefore the prophet was very keen to find Islamic system which ensures justice and availability of
... Show MoreThe aim of the research is to study the effect of the roundhouse strategy on the achievement of fifth grade secondary school in physics and their pivotal thinking. The experiment has been applied for obtaining the data, which were processed statistically using the Statistical Package for Social Sciences, the results revealed that the students of the experimental group who studied using the roundhouse strategy was superior to the students of the control group who studied in the traditional method in the achievement exam. The results also show that there are statistically significant differences between the mean scores of the students of the experimental group and the control group in the pivotal thinking exam, in favor of the experimental gr
... Show MoreThis research aims at clarifying the concept of social auditing, which is one of the most important reasons for its emergence is social responsibility accounting and its role in measuring the social performance of enterprises. The study also aimed to know how social auditing has an impact and its role in improving the social performance of business organizations, and the research refers to testing the hypotheses of an impact of social auditing on social performance through a commitment to social responsibility. The research sample consisted of 200 individuals from 20 Algerian business organizations and represented individuals who were researched in managers and em
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