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.
Prison and imprisonment
And their impact on the strengthening of power
In the Qur'anic perspective
The current specialized research tagged (intellectual and artistic concepts of the cultural context and their impact on contemporary ceramic sculpture) paves the way for the emergence of the context in ceramics active in life, so that this relationship will indicate the development and presence of ceramics or not and the volume of its circulation in the joints of the culture of the Arab recipient. As a result, the researcher collected scientific materials to serve the subject of the research in four chapters: Chapter One (General Methodological Framework) To clarify the problem of the research, the importance of the research to achieve benefit in higher education and education for scholars and teachers, while the research aims to revea
... Show MoreThe current research aims to diagnose the nature of the relation between dynamic capabilities as an independent variable and competitive advantage as a respondent variable, and identify the role of each of them in achieving the required performance of the organizations and adapt to the rapid environmental changes. The research was applied to the Iraqi Cement State Company one of the formations of the Iraqi Ministry of Industry and Minerals, and based on the importance of the subject matter of the research and the importance of the research sample and company of inquiry, The researcher adopted the descriptive analytical method in completing his research. The sample of the research was Intention
... Show MoreBackground: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.
Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.
Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de
... Show MoreBackground: fixed orthodontic appliances deleterious influence on gingival health is well documented. Association between weight status and gingival health is presented in many studies. This study aimed to evaluate how early the impact of fixed orthodontic therapy on patients` gingival health, and if there are differences of that impact among different weight status groups. Materials and Methods: Sample consisted of 54 patients (25 males, 29 females; age limits are 16 -18 years) going under the course of treatment with fixed orthodontic appliance. Patients were categorized according to their Body Mass Index (BMI) into 3 weight status groups considering WHO charts in 2007 (underweight, normal weight, overweight and obese), then determinat
... Show Morethis research paper aims at measuring and analyzing the influence of the stock exchange on the economic development in the Kingdom. This is done through comparing the Gross Domestic Product (GDP) as a changeable factor affiliated with some independent variables in the KSA stock exchange. These variables are (All Share Index {TASI}, Market Value, Trade Volume Index, number of companies and number of shares). The study covers the period from 2003 to 2017 and adapts the measuring method in analyzing this relation using the Multiple Linear Regression (Stepwise) and (SPSS). The study affirmed the validity of the
... Show MoreMonetary policy is an important part of the economic policy to influence the monetary aspect of stabilization, for this reason the research will seek to clarify the extent of the impact of monetary policy in achieving monetary stability in Iraq during the chosen research period, because the Iraqi economy suffers from monetary instability due to political and security turmoil, Therefore, an effective and effective monetary policy is required in terms of reducing inflationary pressures to reach the required monetary stability, in order to create the appropriate monetary environment for the work of the economic and productive sectors. Thus, the research adopted a basic hypothesis that monetary policy in Iraq has a clear impact on achieving mon
... Show MoreThe primary aim of this research was to study visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball. A total of 20 volleyball players of Baghdad participated in this study. The sample was homogeneous in terms of height, weight and age of the players. The tests used in the present study were: 1) Visual Spatial Attention Test. 2) Volleyball Spike Test. Based on the findings of the study, the researcher concluded that visual spatial attention has a significant impact on the accuracy of the diagonal spike in volleyball.
The current research aims to diagnose the type and level of influence of social media, whose dimensions are represented by (attitudes towards social media marketing, knowledge and use of social media, influence on the Internet and social media, following up on social media) on customer behavior in its dimensions (attracting attention, raising Interest, desire creation, customer response), and the research sought to answer questions related to the research problem by testing the main hypotheses to explore correlations and influence between the two variables, and to achieve research hypothesis tests, the field study was used, as the research sample reached (135) individuals from the director and the assistant director And marketing personnel
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