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.
BACKGROUND : Bifurcational coronary lesions are
frequent and amounts to almost one fifth of routine
practice concerning up to 15 – 20 % of cases .
Revascularization by percutaneous coronary
intervention ( PCI ), of bifurcational lesion has
become easier by stenting yet it remains a frequent
challenge.
OBJECTIVE : To evaluate the success and hospital
complications of two most frequent technique of stent
deployment in bifurcational PCI.
METHODS : We prospectively analysed the data of
140 consecutive patients with bifurcational PCI at
Ibn_Al-Bitar Hospital for cardiac surgery for the
period from July 2008 to July 2009 .
Depending on whether the side branch was stented or
not, the patient has fa
Abstract [email protected] Background: Acute Traumatic Stress Disorder (ATSD) might be complicated by Post Traumatic Stress Disorder (PTSD). Psychological First Aid (PFA) said to be helpful to reduce the possibility of reduction of ASD and PTSD symptoms. PFA is simple procedure to deliver help & support to victims, may be by some one close to him, quietly and professionally. Iraq has and is still experiencing, continuous traumatic stresses. ATSD is especially seen in war such as during the Gulf War, Embargo and nowadays under the current American occupation. With the extreme shortage of recourses and the given late priority to psychological problems and intervention have disastrous consequences on the psycho-social wellbeing of peop
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ملخص البحث:
ان الله تعالى هو الذي خلق جميع المخلوقات ، والذي بيده الموت والحياة وان كل هذه المخلوقات تحتاج الى اوامر ، وهذه الاوامر الالهية وجهها الله لعبادة بوساطة انبياءه ( عليهم السلام) فكانوا هم اول المستسلمين والمنقادين لأوامره ، فجاءت الآيات الكريمة مخاطبة للأنبياء واقوامهم بشكل عام ولنبينا محمد (r) بشكل خاص.
اما عن المضمون البحثي فقد جاءت مادته مقسمة الى ثل
... Show MoreObjective: To determine the effectiveness of hypothermia on renal functions for patients undergoing
coronary artery bypass graft CABG surgery.
Methodology: A purposive (non-probability) sample of (50) patients undergoing Isolated coronary artery
bypass graft surgery consecutively admitted to the surgical ward, and they were followed up in the
intraoperative, Intensive Care Unit (ICU) and in the postoperative (surgical ward). Post-operative renal function
test (glumeruler filteration rate (GFR) by using the Crockroft-Gault formula and serum creatinine level) was
determined first week post operative and post operative renal function was classified on the base of peak of
the serum creatinine level and decline of glomeru
This study compared in vitro the microleakage of a new low shrink silorane-based posterior composite (Filtek™ P90) and two methacrylate-based composites: a packable posterior composite (Filtek™ P60) and a nanofill composite (Filtek™ Supreme XT) through dye penetration test. Thirty sound human upper premolars were used in this study. Standardized class V cavities were prepared at the buccal surface of each tooth. The teeth were then divided into three groups of ten teeth each: (Group 1: restored with Filtek™ P90, Group 2: restored with Filtek™ P60, and Group 3: restored with Filtek™ Supreme XT). Each composite system was used according to the manufacturer's instructions with their corresponding adhesive systems. The teeth were th
... Show MoreIn this study, Epoxy Resin plates was prepared by mixing epoxy(A) and hardner(B)with ratio(A:B) (3:1) with different thickness (0.3-0.96)cm. The effect of thickness on optical properties have been studied (absorption ,transmission ,reflectance) also the optical constant were found like (absorption coefficient, extenuation coefficient and refraction index) for all of the prepared plates. The results have shown that by increasing the thickness of plates., the absorption intensity increase in which at plates thickness (0.3-0.96)cm the absorption intensity were(1.54-1.43) respectively, and since absorption peak for epoxy occur in ultraviolet region and exactly at wavelength(368)nm and energy gap(Eg=3.05 eV) thus their good transmittance in the
... Show MoreBackground: Conventional MR imaging is essential for diagnosis and evaluation of the posterior fossa tumors Objectives: To assess the value of diffusion weighted imaging and apparent diffusion coefficient in making distinction between different histological types of posterior fossa tumors.
Type of the study: Cross-sectional study.
Methods: Brain MRI and DWI assessed 19 patients (12 female and 7 male) with MRI diagnosis of posterior fossa tumors. absolute ADC values of contrast -enhancing solid tumor region and ADC ratio of solid tumor to ADC of normal -appearing deep White matter were compared with histological diagnosis postoperatively .The m
... Show MoreBackground: Injuries to blood vessels are among the most dramatic challenges facing trauma surgeons because repair is often urgent, the surgeon has to decide between management options (open or endovascular), and gaining control and reconstructing a major arterial injury can be technically demanding .
Objective:,To analyze the cause of injury, surgical approach, outcome and complications of axillary artery injuries.
Methods A descriptive cross-sectional study on fifty patients at Ibn-Alnafees hospital in Baghdad from January 2005 to December 2010
Results Males were more commonly affected than female with ratio of 6.1:1. Most injuries were caused by bullet and shell (84%), followed by stab wounds (10%) and blunt trauma (6%). Pati
Let be a commutative ring with identity, and be a unitary left R-module. In this paper we, introduce and study a new class of modules called pure hollow (Pr-hollow) and pure-lifting (Pr-lifting). We give a fundamental, properties of these concept. also, we, introduce some conditions under which the quotient and direct sum of Pr-lifting modules is Pr-lifting.