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.
Financial inclusion refers to the access of financial services at low cost and high-quality from the formal financial sector to all segments of society, especially marginalized groups, and then use and benefit from them. Financial inclusion is also associated with banking stability, as well as with financial integrity and financial protection for the consumer, therefore, it achieves a number of objectives, the most important of which is to support and enhance banking stability. This is what made it attract the attention of many countries and central banks recently.
The study aims to show the impact of financial inclusion indicators on ban
... Show MoreThe concept of tolerance is gaining its importance in the midst of an international society suffering from violence, wars and internal and international crises. It is practiced by extremist and extremist forces and movements acting in the name of religion to exclude the different Muslim and non-Muslim people according to the unethical practices and methodologies of Islamic law and reality. , Cultural, civilization .. that distinguish our world today. The society today is suffering from the ideas of the intellectual and aesthetic views of the different ideologically, ethnically, culturally and religiously in the world of the South. This is what the end-of-history thesis of Fukuyama and the clash of civilizations represented to Huntington.
... Show MoreTolerance and its impact on building society
The research talks about the interest and its impact on polygamy as a legitimate social psychological issue, where she talked about the concept of polygamy, and evidence of the legitimacy of polygamy, and clarify the conditions, and then touched on the great interests for which the law allowed polygamy, and mentioned some practical models in polygamy, including What is in the interest of men in pluralism, including in the interest of women in pluralism, including in the interests of both sexes in pluralism .
Objective of the research This study aimed to manufacture an innovative device that enables the player to walk after the operation and improves functional efficiency through improvement in the range of motion as well as improvement in the size of the muscles working on the knee joint Imposing research There are statistically significant differences between the pre and posttests of the experimental and control groups, there are Statistically significant differences between the post-tests between the experimental group and the control group in favor of the experimental group of the research sample. The researchers used the experimental approach by designing the control and experimental groups with a test (pre-post) for the suitabili
... Show MoreIn Iraq, government contributions to the public companies have become a very important aspect which contributes to the survival and sustainability of these institutions as it consider one of the main sources of funding, if not it consider the basis of funding.
According to the vital roles assigned to these institutions to follow up, which usually include important activities in the national economy, the research focused on studying the field reality of the method used in evaluating the stock of total production and purchases of goods for the purpose of selling the strategic commodities of the General Company for Grain Trade. As a result, the aim of this study came to came to highlight&n
... Show MorePurpose – The main purpose of this research is to highlight the main role of strategic leadership skills for top managements in accessing to effective management in accordance with the (VUCA Prime) methodology in (VUCA) environment as Miniature virtual environment, which refers to (Volatility), (Uncertainty), (Complexity), and (Ambiguity).
methodology – To achieve the research objective, this study selected the quantitative approach in research design, Questionnaire was used as the main instrument for data collection, the sample comprised the opinion poll (106) individual who functions as a head department. (Structural equation modelling by (Smart Pls3)
... Show MoreA simple, precise, and sensitive spectrophotometric method has been established for the analysis of doxycycline. The method includes direct charge transfer complexation of doxycycline withp-Bromanil in acetonitrileto form a colored complex. The intensely colored product formed was quantified based on the absorption band at 377 nm under optimum condition. Beer’s law is obeyed in the concentration range of 1–50 μg.mL-1 with molar absorptivity of 1.5725x104 L.mol-1.cm-1, Sandell's sensitivity index (0.0283) μg.cm-2, detection limit of 0.1064 μg.mL-1, quantification limit 0.3224 μg.mL-1 and association constant of the formed complex (0.75x103). The developed method could find application in routine quality control of doxycycline and has
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