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.
Th paper scientifically deals with the Syrian crisis events erupted in 2011 using the historical descriptive and analytical approaches. The importance of the paper comes from the serious crisis that occurred in a region rich of historical crises, and natural resources attracting the attention of the major countries. The paper aims to show the Syrian crisis, its importance to Russia, the United States, and the regional countries, its impact on Russia economically and politically after the intervention, and Russia’s achievements on a global level holding the influential power on international decisions and other global events. The new Russian strategy has proven its worth in preserving its strategic interests as it could help the Syrian
... Show MorePurpose – measure the relationship between operation management strategies as an independent variable on the customer's delight as an approved variable.
Design/methodology/approach – The research sample vocabulary included sales representatives and customers of the researched markets at a rate of (100%). The recovery rate is (95) Customers and (95) delegates for the products for the factory in neighbourhood (Banooks and Karrada ) regions were randomly chosen from an open community in these two residential areas. Statistical methods were used (arithmetic media, standard deviations, t-test, correlation coefficient (Horst), simple regression analysis).
Findings – The people in charge of the factory management nee
... Show MoreBackground: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po
... Show MoreObjective(s): The study aims at evaluating pregnancy-related health behaviors for pregnant women, and to identify the association between pregnancy-related health behaviors and their demographic characteristics of pregnant woman’s age, education, employment, residential area and monthly income.
Methodology: A descriptive study is carried out for the period from December 14th, 2020 to June 20th, 2021. This study was conducted through a non-probability (convenience) sample of 150 pregnant women attending, Abo Ghareeb primary health care sector in Abo Ghareeb spend. The sample has been collected by using the instrument to gather data and accomplish the study's objectives. A questionnaire is composed of (29) items and it is divided into
In this work, a comparative analysis for the behavior and pattern of the variations of the IF2 and T Ionospheric indices was conducted for the minimum and maximum years of solar cycles 23 and 24. Also, the correlative relationship between the two ionospheric indices was examined for the seasonal periods spanning from August 1996 to November 2008 for solar cycle 23 and from December 2008 to November 2019 for solar cycle 24. Statistical calculations were performed to compare predicted values with observed values for the selected indices during the tested timeframes. The study's findings revealed that the behavior of the examined indices exhibited almost similar variations throughout the studied timeframe. The seasonal variations were
... Show MoreFlexible paving is the most popular type of paving used in road building and one of the biggest problems facing the world's paving business is the rising demand for scarce natural resources. Uncontrolled. Numerous studies have shown that secondary materials reduce the need for traditional materials, offer efficient waste disposal technology and lower the overall cost of paving. The current study aimed to evaluate the efficiency of both fibers and dust on the sustainability and cost of flexible pavement by studying each of polyester fibers as a waste of the textile industry and fibers or rubber particles as one of the rubber waste products, in addition to studying the efficiency of using cement dust and marble dust on the paving proc
... Show MoreThe current research problem is focused on the level of human resource managers' performance of their contemporary roles and the impact of this on achieving organizational excellence. The research aims at diagnosing and interpreting the nature of the relationship between the roles of human resource manager and organizational excellence. ), And oil companies located in Baghdad governorate. The research included (boards of directors), and collected data from (83) respondents representing the research community exclusively and comprehensively
represented in the positions of function (Directors-General, Associate Directors-General, heads of departments, divisions and divisions). (49) questions, as well as th
... Show MoreThis study has been undertaken to postulate the mechanism of impact test at low velocities. Thin-walled tubes of 100Cr6 were deformed under axial compression. In the present work there are seven velocities (4.429,4.652,5.240,5.600,5.942,6.264, 6.569) m\sec were applied to show how they effect the load, change in length, also the kinetic energy. However, the comparison between the obtained results and the other studies (Alexandar[3] , Abramowicz[4], Ayad[5]) was made the present work and Ayad data show good agreement. Load, change in length, kinetic energy were determined to understand the impact test.