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.
The evolution in materials’ technology in the last decades resulted in interesting projects that aimed at preserving the environment and energy and reduce pollution. They have been taken the principles of environmental design as a basis for architectural thought, starting from the early stages of the design process ending in choosing appropriate building materials to achieve sustainable buildings, but these trying are limited in our local environment and there isn’t demanded seriousness. The research problem emerges in the ignorance of the environmental aspect (ecological system) when selecting building materials during design process to achieve sustainable buildings. The aim of this research is revealing the mechanisms of selecting
... Show MoreThe research aims at shedding light on the impact of information technology in reducing tax evasion in the General Authority for Taxation. In order to achieve this, the research relied on the analysis of its variables as a main tool for collecting data and information. The results showed that there is a positive and positive effect of information technology on tax evasion. The impact of information technology on increasing tax revenues and reducing the phenomenon of tax evasion In the performance of the research sample, the research sought to highlight the importance of tax information technology through its data and information to the tax administration for the purpose of completing the process Taxpayers for persons subject to income ta
... Show MoreAs we have said that the reasons for abortion are many and varied them to be for
the purpose of treatment or the protection of the mother of the loss or that the abortion
of an act intended purpose of birth control or other reasons is the statistics that are
spread in the world that about 50-60 million abortions annually in the world If this
abortion criminal who is loss of the lives of fetuses and a disgrace to the preachers to
the progressive and liberal, secular, and because they were not able to maintain
human life after leaving the obligation to approach Islam and because life support is
the highest things, which is one of the necessities of the five obligatory street
maintenance came verses warn those who un
يسعى هذا البحث الى تقديم اطار عملي ونظري حول موضوع "تأثير الاقتصاد المنزلي في تعزيز الاداء العالي" وتم اختبار مخطط الدراسة الفرضي في القطاع التعليمي الحكومي في محافظة البصرة ,ويتضمن عدد من تشكيلات الجامعة التقنية الجنوبية. واستخدمت الاستبانة والمقابلة الشخصية كأسلوب لجمع البيانات للدراسة وكان حجم العينة114 موظف. وقد استخدمت عدد من الاساليب الاحصائية لاختبار فرضيات الدراسة. واظهرت النتائج بأن هناك تأثير ايج
... Show MoreReceipt date:11/19/2020 acceptance date:10/1/2021 Publishing date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
Human rights are one of the basic concepts of modern and contemporary times, and political thought as the origin of political science and its source of knowledge have impact in this science and its branches
... Show MoreThis research aims to test the effect of strategic cohesion with its dimensions (organizational excitement, organizational casting, organizational synergy) as an independent variable on administrative excellence as a dependent variable in the Ministry of Planning, and through surveying several employees (general managers, heads of departments, and units managers). As a research community, and based on the importance of the research topic in the aforementioned research community. The researchers have adopted the descriptive-analytical using the questionnaire as the main data collection. 155 questionnaires were distributed, yet,114 of them were retrieved and 110 were used for final statistical analysis. The researchers used the relev
... Show MoreBackground: The patient's vital signs must stay stable pre a pulmonary function test since the approach demands the patient to breathe slowly and deeply and exhale quickly. However, events that cause variations in normal vital signs may impact the patient. Many strategies can be utilized to stabilize vital signs, including music treatment. The purpose of this study is to compare the effectiveness of music therapy on the vital signs of client's pre a pulmonary function test. Methods: An experimental design study with an application (pre-test, post-test), to determine the effectiveness of music therapy for clients pre pulmonary function test for 106 clients in Al-Diwaniyah, Al-Shamiya, and Al- Hamza public hospitals In Iraq. Parti
... Show MoreThis work deals with determination of optimum conditions of direct diffusion bonding welding of austenitic stainlesssteel type AISI 304L with Oxygen Free High Conductivity (OFHC) pure copper grade (C10200) in vacuum atmosphere of (1.5 *10-5 mbr.). Mini tab (response surface) was applied for optimizing the influence of diffusion bonding parameters (temperature, time and applied load) on the bonding joints characteristics and the empirical relationship was evaluated which represents the effect of each parameter of the process. The yield strength of diffusion bonded joint was equal to 153 MPa and the efficiency of joint was equal to 66.5% as compared with hard drawn copper. The diffusion zone reveals high microhardness than coppe
... Show MorePrediction of accurate values of residual entropy (SR) is necessary step for the
calculation of the entropy. In this paper, different equations of state were tested for the
available 2791 experimental data points of 20 pure superheated vapor compounds (14
pure nonpolar compounds + 6 pure polar compounds). The Average Absolute
Deviation (AAD) for SR of 2791 experimental data points of the all 20 pure
compounds (nonpolar and polar) when using equations of Lee-Kesler, Peng-
Robinson, Virial truncated to second and to third terms, and Soave-Redlich-Kwong
were 4.0591, 4.5849, 4.9686, 5.0350, and 4.3084 J/mol.K respectively. It was found
from these results that the Lee-Kesler equation was the best (more accurate) one
Objective: This study aimed to evaluate the effect of coating titanium (Ti) dental implant with polyether ketone ketone (PEKK) polymer using magnetron sputtering on osseointegration, trying to overcome some of the problems associated with Ti alloys. Material and Methods: Implants were prepared from grade (II) commercially pure titanium (CP Ti), then laser was used to induce roughness on the surface of Ti. PEKK was deposited on the surface of Ti implants by radiofrequency (RF) magnetron sputtering technique. The implants were divided in to three groups: without coating (Ls), with PEKK coating using argon (Ar) as sputtering gas (Ls-PEKK-Ar), and with PEKK coating using nitrogen (N) as sputtering gas (Ls-PEKK-N). All the implants were implante
... Show More