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 aims to determine the impact of the strategy performance evaluation and of the Standards (leadership, people, knowledge, processes, financial) in the achievement of organizational effectiveness in accordance with the dimensions (planning and setting goals, Exploitation of the Environment, achieve the goals, the ability to adapt, information management and communications) and the relationship between them, the problem of the research in the growing interest in the process of performance evaluation for organizations, the erroneous belief that the performance evaluation activity is useful, and the fact that performance evaluation process is one of the main tasks of the work of the Office of the Inspecto
... Show MoreSouth Sudan is known by its tribal and racial variation .Tribal Perception represents the
procedure of dealings in Southern society .And that what make Sudan as a stable country that
suffer from divisions . Everybody wants to rule in spite of his inability and un qualification
which enables the establishment of an urbanized country .the frustration of the state in
handling the interior variety on religious, tribal and racial basis and contracting national
ideality in spared by shared ingredients between gathered groups in one state, all these reasons
make it hard to create a united national identity which is able to unite atheist and religious
parties together. Due to this ,the study is established to clarify the nat
A collection of pictures of traditional Kurdish women's national clothing and contemporary clothing was collected. A visit was also made to the city of Sulaymaniyah and the city of Halabja to find out the foundations of traditional clothing for the Kurdish regions and the impact of contemporary fashion on traditional dress. Which represents the culture and regionalism and reflects the picturesque nature of northern Iraq, and in order to complete the study, the parametric measurements of the clothes were analyzed and the graphs of the dress and its accessories were re-drawn to understand and make a comparison between them to study the clear influences and changes and examine the possibility of benefiting from them in sewing contemporary f
... Show MoreBreak in the bond and its impact on the difference of scholars
Scams remain among top cybercrime incidents happening around the world. Individuals with high susceptibility to persuasion are considered as risk-takers and prone to be scam victims. Unfortunately, limited number of research is done to investigate the relationship between appeal techniques and individuals' personality thus hindering a proper and effective campaigns that could help to raise awareness against scam. In this study, the impact of fear and rational appeal were examined as well as to identify suitable approach for individuals with high susceptibility to persuasion. To evaluate the approach, pretest and posttest surveys with 3 separate controlled laboratory experiments were conducted. This study found that rational appeal treatm
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مجلة العلوم الاقتصادية والإدارية المجلد 18 العدد 69 الصفحات 318- 332 |
Water provision is sensitive to climate change, and agricultural production and food supply are sensitive to water availability. Water scarcity affects food security and agricultural economic development through changes in agricultural production and changes in the composition of produced goods. Recent droughts also led to a decrease in the volume of water allocated to agriculture, which led to a decrease in total agricultural production and exports, and this has subsequent impacts on food security and economic development. The research aimed to measure the impact of water scarcity on agricultural economic development for the period 1990-2022. The research included three behavioral equations with three endogenous variables: the cult
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