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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 2017
Journal Name
Journal Of Economics And Administrative Sciences
Robust Queues Models and its Role in Improving Performance in the City of Medicine / Baghdad Teaching Hospital / Clinic Internal Medicine Advisory
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The purpose of this research is to a treatment the impact of Views outliers to the estimators of a distributed arrival and service to the theory of queues and estimate the distribution parameters depending on the robust estimators, and when he was outliers greatest impact in the process of estimating the both distributions mentioned parameters, it was necessary to use way to test that does these data contain abnormal values ​​or not? it was used the method ( Tukey ) for this purpose and is of the most popular ways to discover the outliers , it shows that there are views abnormal (outliers ) in the estimators of each of the distributional arrival and service, which have a significant impact on the calculation of these estimato

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The reflection of strategic knowledge management on an improvement of excellent performance: A survey study at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII)
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The current study aims to investigate the effect of strategic knowledge management practices on an excellent performance at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII). The present research is designed according to the descriptive method. To achieve the mentioned research objective, the researchers used the questionnaire as the main data collection tool. The research sample was 150 managers who are working at the top and middle management levels. To analyses the data gathered and reaching the results, several statistical techniques were used within AMOS.V25, SPSS.V21Software, This study reached a set of results, the most important of which is the existence of a positive correlat

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Publication Date
Mon Mar 17 2025
Journal Name
Medicine Advances
Alone in the Mind: Review of Research Examining the Link Between Loneliness and Dementia
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This narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all‐cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
E-Learning (Benefits and management systems)
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E-learning seeks to create an interactive learning environment between the teacher and the learner through electronic media conveying in more than one direction, regardless of how the environment and its variables are identified. It also develops skills necessary to deal with technology in order to be able to take into account the individual differences between them and helps e-learning teacher and learner to achieve the goals set in advance and identify educational objectives in a clear manner. The research aims to identify e-learning in its benefits and management systems. It has three sections dealt with in the current research. Chapter II concentrates on the research Methodology, which consisted of three sections: The first s

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Publication Date
Mon Nov 15 2021
Journal Name
Studies Of Applied Economics
The Role of Market-Share Management Strategies in Explaining the Stocks Performance Variance of a Number of Industrial Companies- An Analytical Research
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The study aims to know the nature of the expected relationship between market share management strategies and the variation in the performance of the shares of a number of Iraqi industrial companies listed in the Iraqi Stock Exchange. For the period (2005-2018) in the light of both the monthly closing prices and sales volume during the research period, the (Panel Data) method was relied on through a stylistic test (fixed effects model and random effects model), and the results determined the need to adopt the fixed effects model method for sample data and test Assumptions, the results showed the positive impact of market share according to its strategies on the performance of stocks according to its studied indicators (Treynor index

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of the successful managerial leaders in crises management
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This research is a modest contribution to Put the finishing touches on therole of managerial leaders represented by static companies belonging to theministry of transport and communication/ [iraq] . the research has adopted thedescriptive. Analytical methodology and field study technique, using thequestionnaire as a tool for data collection [58] forms Nar, been distributed tothe research sample. The sample has been deliberately selected {generalmanager, as assistant general manager and heads of department}. Thequestionnaires and the main hypotheses of represented by the existence ofsignificant correlation and impact between successful managerial leadershipand crisis management using the software {SPSS}, were analyzed. Resultswere identic

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Influence of Internal Sulfate Attack on Some Properties of Self Compacted Concrete
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      Self-compacted concrete (SCC) is a highly flowable concrete, with no segregation which can be spread into place by filling the structures framework and permeate the reinforcement without any compaction or mechanical consolidation ACI 237R-14. One of the most important problems faced by concrete industry in Iraq and Gulf Arab land is deterioration due to internal sulfate attack (ISA) that causes damage of concrete and consequently reduces its compressive strength, increases expansion and may lead to its cracking and destruction. The experimental program was focused to study two ordinary Portland cements with different chemical composition with (5, 10 and 15) % percentage of high reactivity metakaoline (HRM)

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Influence of Internal Sulfate Attack on Some Properties of High Strength Concrete
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One of the most important problems that faces the concrete industry in Iraq is the deterioration due to internal sulfate attack , since it reduces the compressive strength and increases the expansion of concrete. Consequently, the concrete structure may be damage .The effects of total and total effective sulfate contents on high strength concrete (HSC) have been studied in the present study. The research studied the effect of sulfate content in cement , sand and gravel , as well as comparing the total sulfate content with the total effective SO3 content. Materials used were divided into two groups of SO3 in cement ,three groups of SO3 in sand ,and two groups of SO3 in gravel. The results show that considering the total effective sulfate con

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Publication Date
Mon Nov 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Use of Thermostone Waste Aggregates for Internal Curing of Reactive Powder Concrete
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Abstract<p>The concrete need curing for cement hydration that is a chemical reaction in each step require water supply throughout the time period. The traditional concrete cured by external method that prevents the concrete surface dry so that keeping the concrete mixture wet and warm. The internal curing was adopted in normal and high strength concrete such as reactive powder concrete. In present paper, experimental approach is to study the mechanical properties of reactive powder concrete cured internally with thermostone material. The materials that adopted to evaluate and find out the influences of the internal curing on the mechanical properties of reactive powder concrete is focused with d</p> ... Show More
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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Influence of Internal Sulfate Attack on Some Properties of High Strength Concrete
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One of the most important problems that faces the concrete industry in Iraq is the deterioration due to internal sulfate attack , since it  reduces the compressive strength and increases the expansion of concrete. Consequently, the concrete structure may be damage .The effects of total and total effective sulfate contents on high strength concrete (HSC) have been studied in the present study.

The research studied the effect of sulfate content in cement , sand and gravel , as well as comparing  the total sulfate content with the total effective SO3 content. Materials used were divided into two groups of SO3 in cement ,three groups of SO3 in sand ,and two groups of SO

... Show More
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