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
The Research Includes Two Variables : First , Academic Accreditation with his dimensions ( Educational Context , Educational Inputs , Educational Process , Educational Outputs , Feedback ) , And The Second : Strategic Performance With His dimensions ( Financing , Satisfaction Stakeholders , Internal Processes , Learning And Growth ) , The Research Highlights On The Academic Accreditation System Which Is Considered A Major And Important Systems Can Through Which Administration Of Activities And Programs Institutions Of Higher Education , As This research aims to determine his relationship And The Extent Of Its Effect In The Strategic Performance , And It Includes The Research C
... Show MoreAbstractThe research aims to identify the impact of the different methods in calculating the Items sensitivity coefficient on the standard characteristics of the Criterion-Referenced test in the measurement and evaluation material. The research sample consisted of (35) male and female students, who were chosen by the intentional method. The researcher prepared learning-teaching program in constructing the content of the measurement and evaluation material for non-specialized departments, prepared an achievement test in its equivalent forms, identified the results of agreement between the methods used in analyzing the items of the criterion-referenced test, and compared the standard characteristics of the achievement test, both according to
... Show MoreAutorías: Abdulsahıb Mohammed Muneer, Habeeb Sabhan Maytham, Kazim Abed Emad. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 1, 2021. Artículo de Revista en Psyke.
The current study is based on previous findings, where corporate governance (CG) significantly increased corporate social responsibility (CSR) to enhance transparency while reducing the tendency of corporate management to engage in earnings management (EM). A sample of 11 Iraqi banks listed on the Iraq Stock Exchange from 2010 to 2020 was selected. The CG was included in the board size and board independence apart from the variables of Chief Executive Officer (CEOs) gender, majority shareholder ownership, foreign ownership, and institutional ownership. The CSR included the wage growth rate, bank contribution growth rate for social security, training programmes, subsidies, environmental protection, and bank compliance with the law. Specifica
... Show MoreThe Political Thinking Regarded as an important element for the formulation of the stat, weather in its formation, the structure of it s entity, its political system and it s governmental instruments .The political thinking can not act without determined strategy, So they intend to work hard to formulate a railed strategy that make them able to determine its directions to general issues.
The Study aimed to solve the problem through the following question:
1- What are the levels of Political Thinking and Strategic Analysis in the financial ministry?
2- What are the relation ship between the dimensions of Political T
... Show MoreThe exchange rate is the backbone of any economy in the world, whether developed or developing, where most countries adopted many policies, in order to ensure the stability of the exchange rate of the currency, because of its importance as a link between the local economy and the others ,And it contribute in the achievement of internal and external balance and despite the many different factors that affect it, but there is wide consensus on the effectiveness of the role of spending and the currency window in the exchange rate of the Iraqi dinar, especially in the Iraqi economy, effectiveness As the increase in government spending lead to an increase in the supply of money and increase domestic demand and high pr
... Show MoreBaghdad, one of Iraq’s most crowded cities, faces severe air pollution caused by rapid population growth, dense traffic, and limited green spaces. Monitoring at five sites in Al-Rusafa during 2024–2025 showed that pollutant levels, especially PM₁₀, PM₂.₅, and TSP, exceed national and global limits. The most polluted areas lacked vegetation and had heavy traffic, while greener zones showed lower concentrations. Seasonal variations were evident: winter had the highest pollution, summer the lowest but with greater plant stress. Ascorbic acid and the Air Pollution Tolerance Index (APTI) proved reliable indicators of plant resistance. Overall, the study confirms plants’ role as effective bio monitors and stresses the need f
... Show MoreIntroduction: We aimed to assess the impact of adhesive and wires types on the tensile bond strength of fixed lingual retainers. Methods: A total of 160 intact bovine teeth were collected, cleaned, stored in 25% sodium hypochlorite, and randomly assigned to two groups based on the adhesive type: a two-step adhesive and a one-step adhesive. Each group was further divided into four subgroups based on the type of lingual retainer wire, which included (A) 8-strand braided stainless steel wire, (B) three-strand titanium retainer wire, (C) stainless steel chain, and (D) fiber-reinforced retainer. A tensile bond strength test was conducted using a universal testing machine at a controlled speed of 10 mm/min. Result: The 8-strand braided stainles
... Show MoreAbstract:
Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear
... Show MoreThis paper aims at studying the illocutionary speech acts: direct and indirect to show the most dominant ones in a presidential speech delivered by the USA president. The speech is about the most critical health issue in the world, COVID-19 outbreak. A descriptive qualitative study was conducted by observing the first speech delivered by president Trump concerning coronavirus outbreak and surveying the illocutionary acts: directive, declarative, commissive, expressive, and representative. Searle's (1985) classification of illocutionary speech acts is adopted in the analysis.
What are the main types of the illocutionary speech acts performed by Trump in his speech?; Why does
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