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 article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
... Show MoreA New ligand, N-(2-oxo-1,2- Dihydropyrimidin-4- ylcarbamothioyl) Acetamide (DPA) was prepared by reaction of iso thiosyanate derivative with Cytosine. The ligand has been characterized through elemental analysis, H1 NMR, C13NMR, FT-IR, and UV Visible spectra, such ligand’s transition metal complexes have been characterized through conductivity measurement, FT-IR, UV Visible spectra and magnetic susceptibility, all the complexes of this ligand are solid crystal and molar ratio (2:1) (ligand: metal). The form of molecular for these complexes octa hedral. The general formula [M(DPA)2Cl2], where M+2 = (Mn, Co, Ni, Cu, Zn, Cd, Hg).
KE Sharquie, AA Noaimi, BAM Saleh, 2015
The innate art,is a major tributary in the art world, It is a bold achievement, has a special flavor, With self-identity, linked to the origins and roots of human ,That goes back to the past and the history and culture of peoples. This business is not limited to only aesthetic side, but is loaded with religious and magical experience, and have social functions, This creations stayed live, breathe, grow, and change with the transformation of society, these processors emerged, from local people have not been trained academically.Their Elvis came from community culture,Which are, Mesopotamian thoroughbreds.This culture that we desperately need today, in order to increase ourselves Iraqi force, In the face of the modern world, which is locke
... Show MoreThis research is based on monitoring the local and environmental technologies in the design of the temporary hotel units (nomadic tents) in the desert in the south of Jordan in order to air condition them in summer and winter, maintaining the Jordanian identity, that they are presented with the form and technologies of the age in order to get to the universality.
The research adopted the descriptive analytical method and the researcher conducted the analysis of SWOT specified for the analysis of the positive and negative aspects in the design of the temporary hotel units and comparing them with the case studies available in the chosen research area "the Jordanian golden triangle", through the elements of the case under study. The res
The results of the current study showed that the liver of H. javanicus appeared as large lobulated organ divided into six distinct lobes, that filled the cranial region and little extended to the middle region of abdominal cavity. On the other hand, liver of S. carolinensis laid against the diaphragm, occupied the cranial region of the abdominal cavity and consisted of five lobes. The liver is surrounded with a thin capsule of dense regular collagenous connective tissue and few numbers of smooth muscles fibers can be seen in the capsule that covered the squirrel liver. The liver parenchyma divided into a large number of interconnected hepatic lobules marked only by the abundant amount of connective tissue bordered the triads, and within the
... Show MoreThis paper set forth the spatial suitability of the informal settlement supposed to be distributed by the Iraqis government to poor people. The Iraqi government identified 9 locations of informal settlement in Baghdad city and acceptance it as a reality as a help for them to getting home. In this paper I discovered the suitability of those locations which one will be suitable more than others for living. The analysis process was applied using the GIS environment – spatial analysis. According to the results, It has been identified as the most important measures to identify which one of these areas suitable for development for housing by using some criteria (Distance from the city center, Proximity from transport routes, Proximity of high v
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