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.
الخلاصة Bahraini Parliamentary Elections and their Impact on the Popular Uprising) Bahrain has a distinguished constitutional and parliamentary experience, which distinct it from the other Gulf Cooperation Council (GCC) countries. Its experience in this area is the second after the experience of Kuwait to establish a system of government based on modern constitutional principles. As the government presented the Constitution to the Constituent Assembly elected by people and approved in 09/06/1973. After that, it witnessed the birth of the first parliament elected by the people in 1973, but the experiment did not last long and the parliament dissolved by Prince, and didn’t determine the period of the return of the working with the
... Show MoreThis research test the relationship and the effect of an explanatory variable transparency in the organizational reputation responder variable by senior management in the departments of the Ministry of Housing and Construction centrally funded, As well as come out among other recommendations contribute to the achievement of organizational reputation of the organizations surveyed. Given the importance of the research topic for the public sector and the community and the environment in which they operate researcher designed questionnaire containing (30) items, and collected data from (92) respondents, representing the research community (eight establishments) exclusively and comprehensively, relying descriptive analytic
... Show MoreIslam was keen to get every man and woman a share of those benefits and wanted to marry and urged him. In order to unite efforts and articulates the arrow and clarifies the goal and I have a share in building a sober Islamic society, for all this and other research title is ((modern or planting and its impact on marital happiness)).
The current study investigates the impact of virtual reality technology on industrial product design. The focus of this study is on the development of industrial products that utilize virtual reality technology, specifically examining the effects of this technology on the visual and design aspects of these products. The aim is to continuously improve the functionality of industrial products and enhance the user experience through virtual reality integration.
The first chapter of the study addresses the research problem, which centers around exploring the technological influence of virtual reality used in industrial products and understanding the functionalities it brings to the design process. Virtual reality technology facilitates th
Abstract Globalization dominated in the last decade of the twentieth century and the eve of the third millennium over economic,politics,psychology,culture,communications and information sciences,it's a historical phenomenon refer to many important transitions in humanitarian life.It foxes on that state has illusion its historical role in the psychologist,economic and political buldings. Globalization issue and its influence in North Korea put a spotlight on political,economic and cultural situations,the political system resists any change with many limitations on political freedoms,human rights and political multiplicity.Libralism trends and free market are so weaken when it comparing within the bad economic situation of the coun
... Show MoreGypseous soils are considered one of the most problematic soils. The skirted foundation is an alternative technology that works to improve the bearing capacity and reduce settlement. This paper investigates the use of square skirted foundations resting on gypseous soil subjected to concentric and eccentric vertical load with eccentricity values of 4, 8, and 17 mm in 16 experimental model tests. To obtain the results by using this type of foundation, a small-scale physical model was designed to obtain the load–settlement behavior of the square skirted foundation; the dimension of the square footing is 100 mm × 100 mm with 1 mm thickness, the skirt depth (
In accounting studies, more than one method is used to measure income and balance sheets elements. One of these methods is called the fair value, which use to determine the assets and liabilities ad it includes the benefits or self-satisfaction ability. This paper aims to focus on the importance of fair value as a basis of accounting measurement and its effects to achieve the relevant characteristics by using the equation is used by (Kythreotis) in his research, And Also , Editing this equation depending on the financial data and information of Iraqi Banks as a case.
The research aims to know the concept of politic behavior as one of the important behaviours in the different fields and sectors. It is considered to be part of the organizatial work to face the expected risks. It includes two group of factors personal (self –monitors, locus of control ,expectation s of success, perceived job alternatives)and organizational(promotion ,division resources,role ambiguity ,democratic decision)studied by the researcher in the frame of the relationship with the variable of display continuous trust matain which includes two variable (build trust mantain, display trust continuouness)through applied frame by random sample consists of (90)employee at Farouq State
... Show MoreThe current work aims to evaluate the association between genetic mutations in thymidylate synthetase (