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 aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in
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The Central Bank is the backbone of the banking system as a whole, and in order to maintain the banking system, one of the most important functions that the Central Bank performs is the function of supervising and controlling banks, with several tools and methods, and one of the most important of these tools is its creation of the function of a compliance observer, which obligated commercial banks to appoint a person in A bank that performs this function according to certain conditions and granting it some powers that would build a sound and compliant banking system. The function of the compliance observer is to follow up on the bank’s compliance with the instructions and decisions issued by
... Show MoreThis research is to take advantage of the performance capabilities which the piano has become famous with and transfer the impact of that advantage to the possibilities of playing the violin. The research aims to introduce the effect of using the piano on the development of the violinists' musical potential. The research, in its literature, focuses on the interpretation of the impact on the possibility of both instruments (piano and violin) in two main sections: the piano (its origin, potential and role in music) and the violin (its origin, potential and role in music). The procedures of the research consisted of presenting a special analysis of a questionnaire consisting of a number of questions presented by the researcher to her resear
... Show MoreThis research means a study (the impact of the Arab-Islamic environment on contemporary painting, the artist Abd al-Rahman al-Suleiman as a model). The research falls into two axes: the first: the theoretical axis, and the second: the applied axis. The first axis dealt with an introduction that contained: (the research problem, its importance, its goal, its limits, and the definition of terms). This research aims to uncover (the impact of the Arab-Islamic environment on contemporary painting, and the artist Suleiman was a model). And the research limits spatially: Saudi Arabia, and temporally: 2010-2014. This theme included two topics: The first: the characteristics of the Saudi environment and its impact on art. The second: the s
... Show MoreThe technology in continuous and quick development, that reflects in all parts of our life and interred both scientific and practical fields. Marketing is one of them, a customer’s way to deal with choosing and demanding the product deferent from the traditional way. Some of the buying processes are electronic now, therefore the current research is identifying the digital channels that entered the world of marketing and influenced the activities and types that fall under this name and how it affects in positioning strategy, which is how to install the product or brand in the mind of the customer and was dimensions (brand identity, brand personality, brand communication, brand awareness, brand image), The researcher took t
... Show MoreChina's economic policy and its huge capabilities operate according to an expansion strategy, especially in investing foreign projects, as the past ten years have witnessed a major development in the elements of comprehensive strength, especially in the economic field, in 2014 China launched the largest initiative in the world, represented by the Belt and Road Project (BRI), which links nearly 70 countries, through this project, a very important region has emerged, which is (the port of cadres) in Pakistan, as China has headed towards that region and given the highest importance that is in its interest in the first place regardless of the great Pakistani interest, This is consistent with its future aspirations, especially after breaking
... Show MoreThis research aims to demonstrate the nature and concept of the Corona pandemic, its implications for the global economy, and the management and performance of companies in particular. Additionally, the research intends to measure the impact of the Corona pandemic on companies' financial performance. Listed on the Iraqi Stock Exchange, which has finished compiling its year-end financial statements for 2019-2020. The investigation arrived at several findings, the most significant of which was that most businesses were not prepared for such a crisis technologically or to develop human resources to deal with this pandemic. In addition, most companies experienced a decrease in their financial performance as a direct result of the Corona pandemi
... Show MoreThe aim of this study is to calculate the ene expenditure from fatty substance contents of the
frog. Rana ridibunda during its hibernation. It was found that, almost, all frogs enter
hibernation during the last week of December and emerge from hibernation during the first
week of March. Hence, January and February are considered the hibernation period.
December is the pre-hibernation period and March is the post-hibernation period. The
reduction in percent of body lipid during the hibernation period was 4.8% in males and 7.7%
in females. The reduction in percent of lipid of fat bodies during the hibernation period was
2.758% in males and 0.733% in females.
The calorific value of R. ridibunda lipid amounted to 1233
After the twenty – first century become necessary for us motorcade era in educational a chevements by searching for the best strategies and teaching methods and techniques artotalbagesh resorting to the strategy
Did not use in use in the teaching of the foreseeable material general by voice and teaching perspective for the student of the class fourth science
In particular ,so the researcher asking the question follows:
Can the peer education strategy to have an impact in perspective drawing skill development ?
From here it demonstrated the importance of current research know the impact of p
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