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.
Specialized banks provide their banking activities to their customers at interest rates that are determined according to the approved bank policy, which is almost similar to most or most banks. To satisfy the financial desires of customers and at the same time it is a source of the bank's profits, However, these banks have been introduced to new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) to address the economic stagnation that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives amounting to nearly (15) trillion dinars, which were put forward through private commercial and Islamic banks and specialized
... Show MoreThe research discusses two variables are important, orientation marketing and quality of service, and that the purpose of the research is to see whether the telecom companies applied orientation marketing or not and to what extent is keen to apply it to suit the Iraqi environment as it has been applied research in kork Telecom company and Asia Cell Telecom are sectors service job in the business sector in Iraq, The information was obtained through the design of the questionnaire compatible runway Likert, and distribution (92) questionnaire, which (50) for the company Korek Telecom and (42) of the Asia-Cell, research population sample included a number of staff in the departments and units in the two companies, it has been support
... Show MoreDuring the study the current selection seven stations in the Zab River bottom and the Tigris River took samples a month to study the signs of bacterial contamination study coliform and colon fecal Almsobhaat and Almsobhaat Bazah and the total number of bacteria and bacterial gangrene gas causing Knkeran as well as a study to isolate and diagnose some races and types of bacterial pathogens in water or intensityusing the traditional system and the system of intestinal bacteria
In this search, Ep/SiO2 at (3, 6, 9, 12 %) composites is prepared by hand Lay-up method, to measure the change in the thermal conductivity and Impact Strength of epoxy resin before and after immersion in H2SO4 Solution with a 0.3N for 10 days. The results before immersion decreases with the increase of the weight ratios of the reinforcement material (SiO2), It changed from (82.6×10-2 to 38.7×10-2 W/m.°C) with change weight ratios from (3 to 12) % respectively, but after immersion time in the chemical solution where it was (65.6×10-2 W/m.°C) at the weight ratios (6 %) and became (46.6 × 10-2 W/m.°C) after immersion in sulfuric acid. The results of the Impact strength decreased by increasing the percentage weight ratio, it changed f
... Show MoreThe research aims to shed light on the importance of forensic accounting and its impact on the outcome of the activity of the Iraqi general insurance company by winning the lawsuits filed against the company because the forensic accountant (the judicial expert) possesses the ability to interpret and analyze the data. The research community represents the insurance companies in Iraq. Iraqi insurance, and the researchers adopted the descriptive approach in covering the theoretical aspect and the deductive approach in covering the practical side, depending on the financial statements of the Iraqi insurance company for the years of research.
One of the most important conclusions reached by the researchers was that forensic accounting
... Show MoreThe international financial accounting and reporting standards IFRS/IAS represent the set of rules and foundations that the economic entity must follow in the measurement, presentation, and disclosure of the elements of the financial statements, the implementation of adopting the international financial reporting standards contributes to improving the qualitative characteristics of accounting information, so the current research aims to explain the role of adopting the International Accounting Standard (IAS) in improving the qualitative characteristics as well as analyzing the impact of the adoption of IAS.1 in improving the qualitative characteristics of accounting information within the financi
... Show MoreThe first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreBackground: The main drawback of soft lining materials was that they debonded from the denture base after a certain period of usage. Therefore, the purpose of this research was to determine the impact of oxygen and argon plasma treatment on the shear bonding strength of soft liners to two different kinds of denture base materials: conventional acrylic resin and high impact acrylic resin. Materials and Methods: Heat cure conventional and high impact acrylic blocks (40 for each group) were prepared. A soft liner connected the final test specimen of two blocks of each acrylic material. Shear bond strength (SBS) was assessed using universal testing machine. Additional blocks were also prepared for analyzing Vickers microhardness, contact ang
... Show MoreThe present study aimed to investigate the effects of level pH and the growth phases of Coelastrella saipanensis on Chlorophyll a,b, total, and Carotene. The algae were cultured in BG11 media and grown at different pH levels. We measured chlorophyll a, b, total chlorophyll, growth phases, and carotene concentrations. The results showed that at pH 8.5, the measurements of photosynthetic pigments-chlorophyll a, Chlorophyll b, and the total chlorophyll (0.183, 0.268, and 0.433 mg L-1, respectively). The highest values of chlorophyll a (0.185 mg L-1), and b (0.339 mg L-1), and the total chlorophyll (0.492 mg L-1) were recorded in the stationary phase. In addition, the study found that at pH 8.5 and the beginning of the stationary phase,
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