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.
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, Muhammad and his family
The good and pure and after his companions
God Almighty said: ( ) Do they not contemplate the Qur’an? If it had been from other than God, they would have found in it much discrepancy. God Almighty has made the well-being of people and their lives linked to faith in it. So what is the need of people today to return to the Book of their Lord so that they may return to the right path that God intended for His servants so that they may attain sustenance? Security and the good life. How could it not be, when many of the nations of the world no longer see security or stability because their leaders and politic
... Show MoreThe research in the variables of the political process and government stability tried to show the impact of the political process on political stability first, and then on government stability second, given that the political process that was established in 2005 was aimed at achieving legitimacy, and its most prominent tools are elections, leading to achieving political stability, including government stability. The issue of governmental stability is one of the important issues in Iraq, but it has not been achieved, as a result of several factors, including problems in political action, as the political process has not succeeded in leading Iraq to stability.
The purpose of this study is to evaluate the effect of hydrated lime addition methods as filler replacement on fatigue performance of Hot Mix Asphalt (HMA). Three types of addition methods of hydrated lime were introduced namely dry HL on dry aggregate and saturated surface aggregate above 3% and slurry HL on dry aggregate, ordinary Lime stone powder was reduced by three HL percentage (1.0, 2.0 and 3.0 %). The effect of different methods were investigated on the fatigue properties of HMA using, third-point flexural fatigue bending Test. Pneumatic Repeated Load System (PRLS) was carried out to establish the effect of hydrated lime on the fatigue failure criteria and to select the proper hydrated lime application methods on fatigue behavior o
... Show MoreBackground: The emergence of vaping as a popular alternative to traditional smoking has raised concerns regarding its potential impact on oral health. specifically affects the oral health of dental students, who are not only consumers of these products but also future practitioners tasked with educating patients on oral hygiene and health risks. purpose: This study investigated the dental and oral health impact of VAPE among male dental students. Methods: A self-administered questionnaire comprising 20 questions was meticulously designed to gather relevant data about their VAPE use and its implications on dental and oral health. Results: 43% of participants reported using VAPE, predominantly employing salt nicotine (48.8%) over free
... Show MoreThe ancient Iraqis in the Mesopotamian civilization practiced various sports activities and physical exercises to develop their physical fitness until these practices became a part of their lives and accompanied their religious, social, and military celebrations. Music had a presence in many sports scenes, and the presence of musicians and musical instruments with the armies indicated its great role. In the military scene, the research aims to shed light on the archaeological evidence and evidence of the integration of music with the sports and military scene in Mesopotamian civilization and to explore the impact of music in the sports and military scene of Mesopotamian civilization. The historical approach was adopted in collecting and des
... Show MoreIn the postmodern era, the graphic design styles showed a new visualization method when the graphic designers had changed the traditional conditions by using design elements with new technics for photos, collage and comics illustration. The researcher assumes that the graphic design styles were affected by the art's movement at that period throw the same perspective of view for the concept presented in the art pieces and their entire message. Therefore, the researcher chooses field was the period of 1945-1970 in the USA for the (pop-art and conceptual-art) and explored the main visual effects that expressed the visual dialogue and compared them with the most common design styles ant the same period and location, the results of selected e
... Show MoreMany researchers tried to prevent or reduce moisture damage and its sensitivity to temperature to improving the performance of hot mix asphalt because it is decreasing the functional and structural life of fixable pavement due to the moisture damage had exposed to it.
The main objective of this study is to inspect the effect of (fly ash “3%, 6%, 12%”, hydrated lime”5%, 10%, 20%” and silica fumes”1%, 2%, 4%) referring to previous research by the net weight asphalt cement as a modified material on the moisture and temperature sensitivity of hot mix asphalt. This was done using asphalt from AL-Nasiria refinery with penetration grade 40-50, nominal maximum size (12.5) mm (surface course) of aggregate and on
... Show MoreThe research included four chapters starting with the chapter dealing with the problem of child abuse which was one of the most important educational and social problems faced by children from their parents or family members. The most common forms of abuse are physical and psychological violence. The problem of school delays is also one of the most important educational and psychological issues that concern educators, which occur because of violence and neglect of the family. The study pointed out that domestic violence is one of the issues that has started to alarm both the global and local communities, because childhood is one of the most important stages of the human development system, which is healthy in terms of physical, mental, p
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