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Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associated with Acom aneurysms and provide an illustrative case.

Methods:

We combined our experience of one case of a unilaterally absent ICA associated with an Acom aneurysm with the 33 existing publications on the same subject in the literature, for a total of 40 cases. We provide a detailed systematic literature review of this association of vascular anomalies, exploring different aspects regarding the collateral pathways and how they impact management strategies and propose a management algorithm to deal with such association.

Results:

The mean age was 48.2 ± 16.5 years. The aneurysmal rupture was the most common presentation (75%). Agenesis was observed in 70% of patients, followed by hypoplasia (20%) and, finally, aplasia (10%). Lie Type A was the most common pattern of collaterals (50%), with Types B and D being of almost equal proportions. Most aneurysms were located at the A1-Acom junction contralateral to the anomalous side (Fisher’s Exact test;P= 0.03). One case of temporary clipping was reported in the literature.

Conclusion:

Acom aneurysms in patients with unilateral ICA anomalies, given they are more commonly present contralaterally, could be of acquired etiology, warranting periodic screening in asymptomatic patients. Temporary clipping might be safe in patients with Type D collateral pattern, while those with Types A or B may require intraoperative rupture risk assessment and a tailored management plan to avoid disrupting collateral flow and causing ischemia.

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Publication Date
Thu Jun 01 2023
Journal Name
Iaes International Journal Of Artificial Intelligence (ij-ai)
Innovations in t-way test creation based on a hybrid hill climbing-greedy algorithm
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<p>In combinatorial testing development, the fabrication of covering arrays is the key challenge by the multiple aspects that influence it. A wide range of combinatorial problems can be solved using metaheuristic and greedy techniques. Combining the greedy technique utilizing a metaheuristic search technique like hill climbing (HC), can produce feasible results for combinatorial tests. Methods based on metaheuristics are used to deal with tuples that may be left after redundancy using greedy strategies; then the result utilization is assured to be near-optimal using a metaheuristic algorithm. As a result, the use of both greedy and HC algorithms in a single test generation system is a good candidate if constructed correctly. T

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Publication Date
Mon Sep 12 2022
Journal Name
Electronics
TWGH: A Tripartite Whale–Gray Wolf–Harmony Algorithm to Minimize Combinatorial Test Suite Problem
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Today’s academics have a major hurdle in solving combinatorial problems in the actual world. It is nevertheless possible to use optimization techniques to find, design, and solve a genuine optimal solution to a particular problem, despite the limitations of the applied approach. A surge in interest in population-based optimization methodologies has spawned a plethora of new and improved approaches to a wide range of engineering problems. Optimizing test suites is a combinatorial testing challenge that has been demonstrated to be an extremely difficult combinatorial optimization limitation of the research. The authors have proposed an almost infallible method for selecting combinatorial test cases. It uses a hybrid whale–gray wol

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Publication Date
Sat Feb 21 2026
Journal Name
Journal Of Physical Education
Proposed Exercises Using Flexible Resisters And Their Effect On Developing Strength Endurance And The Performance of Some Offensive Skills In Youth Basketball
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Publication Date
Tue Jan 30 2024
Journal Name
International Journal Of Pharmacy Practice
A Comprehensive Review of Drivers influencing Flu Vaccine Acceptance in the Middle East: Using Health Belief Model
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Rationale, aims and objectives: A review of studies published over the last six years gives update about this hot topic. In the middle of COVID-19 pandemic, this study findings can help understand how population may perceive vaccinations. The objectives of this study were to review the literature covering the perceptions about influenza vaccines and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). Methods: A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions, and Middle East. Empirical studies that dealt with people/ HCW perceptions of influenza vaccine in the Middle East and writt

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Publication Date
Wed Jan 01 2020
Journal Name
Imdc-sdsp
Emotion management among the headmaster of intermediate schools
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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Craniofacial Surgery
Surgical Management of the Recent Orbital War Injury
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Publication Date
Thu Dec 20 2018
Journal Name
Frontiers In Immunology
Resveratrol Attenuates Allergic Asthma and Associated Inflammation in the Lungs Through Regulation of miRNA-34a That Targets FoxP3 in Mice
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Asthma is a chronic inflammatory disease of airways mediated by T-helper 2 (Th2) cells involving complex signaling pathways. Although resveratrol has previously been shown to attenuate allergic asthma, the role of miRNA in this process has not been studied. We investigated the effect of resveratrol on ovalbumin-induced experimental allergic asthma in mice. To that end, BALB/c mice were immunized with ovalbumin (OVA) intraperitoneally followed by oral gavage of vehicle (OVA-veh) or resveratrol (100 mg/kg body) (OVA-res). On day 7, the experimental groups received intranasal challenge of OVA followed by 7 days of additional oral gavage of vehicle or resveratrol. At day 15, all mice were euthanized and bronchioalveolar fluid (BALF), se

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Publication Date
Tue Jul 02 2013
Journal Name
Journal Of Baghdad College Of Dentistry
Local Drug Delivery Systems for Treating Periodontal Diseases: A Review of Literature
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Publication Date
Sat Feb 21 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Local drug delivery systems for treating periodontal diseases (A review of literature)
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In this review of literature, the light will be concentrated on the local drugs delivery systems for treating the periodontal diseases. Principles, types, advantages and indications of each type will be discussed in this paper.

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Publication Date
Fri Jun 20 2025
Journal Name
Journal Of Kufa For Chemical Sciences
Studying Analytical Methods for Monitoring of Antibiotics in Environmental Waters, A review
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In recent years, there has been a rise in interest in the study of antibiotic occurrence in the aquatic environment due to the negative consequences of prolonged exposure and the potential for bacterial antibiotic resistance. Most antibiotic residues from treated wastewater end up in the aquatic environment as they are not eliminated in facilities that treat wastewater. Antibiotics must be identified in influent and effluent wastewater using reliable analytical techniques for several reasons. Firstly, monitoring antibiotic presence in aquatic environments. Secondly, assessing environmental risks, computing wastewater treatment plant removal efficiencies, and estimating antibiotic consumption. Therefore, this work aims to provide an overview

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