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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
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The effect of Analysis of internal environment in the quality of health care service survey study at AL_Elwiya Maternity Teaching Hospital
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he current research aims at showing the correlation and effect of the internal environment analysis in the quality of health service in AL_Elwiya Maternity Teaching Hospital, researcher depended on the integral method in the "analytical descriptive method" for the study of the relation between the main variables and the sub-variables throughout data collection required by the theme of this study, a case study" in tackling the data and information related to the financial aspects of the internal environment.

The problem of the study was manifested in the essential question, that is (is there internal struc

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Publication Date
Sat Nov 30 2019
Journal Name
Journal Of Engineering And Applied Sciences
Using Particle Swarm Optimization Algorithm to Address the Multicollinearity Problem
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Publication Date
Tue May 16 2023
Journal Name
International Journal Of Professional Business Review
The Mediating Role of Operations Management Practices on the Relationship Between the Dimensions of Manufacturing Flexibility and Competitiveness
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Purpose: The aim of this study is to examine knowing the real role and impact of manufacturing flexibility on competitiveness through operations management practices, which is to determine the role and impact of manufacturing flexibility on competitiveness directly in the General Company for the Battery Industry. On the other hand, identifying the indirect role of flexible manufacturing systems in enhancing competitiveness.   Theoretical framework: The main purpose of the theoretical framework is to identify all the dimensions and variables included in the current study, and thus form a deep scientific view of the study and its variables.   Design/methodology/approach: field coexistence, personal interviews, and classification of

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Publication Date
Wed Oct 08 2025
Journal Name
International Journal Of Veterinary Sciences And Animal Husbandry
Review of multidrug sensitivity and resistance in enterococcus
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Review of multidrug sensitivity and resistance in enterococcus

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Publication Date
Wed Oct 08 2025
Journal Name
Philosophy Journal
Critical-cultural discourse and review of political action
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Publication Date
Thu Oct 04 2018
Journal Name
Irrigation And Drainage
Agricultural Irrigation Pricing: Review of Theories and Practices
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Abstract<p>Water pricing and substitution of the costs of irrigation investment operation and maintenance have been controversial issues for a long time. The small charges for irrigation water are addressed, and additionally, the low level of farmers who pay the costs. In a few schemes, expense accumulation rates are close to zero, notwithstanding when water charges are well beneath the cost of operation and maintenance. Water prices are charged to farmers for two essential objectives. The first is to cover the operation and maintenance estimation with the goal that the investment is fiscally practical. Much of the time, costs will likewise need to incorporate a price for the cost of capital required to develop</p> ... Show More
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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Proposed Entropy Loss function and application to find Bayesian estimator for Exponential distribution parameter
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The aim of this paper to find Bayes estimator under new loss function assemble between symmetric and asymmetric loss functions, namely, proposed entropy loss function, where this function that merge between entropy loss function and the squared Log error Loss function, which is quite asymmetric in nature. then comparison a the Bayes estimators of exponential distribution under the proposed function, whoever, loss functions ingredient for the proposed function the using a standard mean square error (MSE) and Bias quantity (Mbias), where the generation of the random data using the simulation for estimate exponential distribution parameters different sample sizes (n=10,50,100) and (N=1000), taking initial

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
A Suggested Model for Using a Students Attendance Management Information Systems/ A Case Study In Lebanese French University/ Erbil
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This study aims to design unified  electronic information system to manage students attendance in Lebanese French university/Erbil, as a system that simplifies the process of entering and counting the students absence, and generate absence reports to expel students who passed  the acceptable limit of being absent, and by that we can replace the traditional way of  using papers to count absence,  with  a complete electronically system for managing students attendance, in a way that makes the results accurate and unchangeable by the students.

            In order to achieve the study's objectives, we designed an information syst

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Publication Date
Thu Jun 26 2025
Journal Name
Plos One
Neurologists’ perspectives on management challenges and mitigation strategies for Parkinson’s disease patients: A qualitative study in Iraq
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Background Parkinson’s disease (PD) is currently the fastest-growing neurological disorder in the world. Patients with PD face numerous challenges in managing their chronic condition, particularly in countries with scarce healthcare infrastructure. Objective This qualitative study aimed to delve into neurologists’ perspectives on challenges and gaps in the Iraqi healthcare system that influence the management of PD, as well as strategies to mitigate these obstacles. Method Semi-structured interviews were conducted with neurologists from five different Iraqi provinces, working in both hospitals and private neurology clinics, between November 2024 and January 2025. A thematic analysis approach was employed to identify the main challenge

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Management of Chronic Osteomylitis
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Background : Bone infections is one of the most challenging orthopaedic complications, with considerable morbidity. There is significant impact on the life of the patients; socially, financially, physically, and mentally and it could be a limb-threatening complication. Osteomyelitis is a bone infection usually caused by bacteria, including mycobacteria, but mainly Staphylococcus aureus which is the most commonly responsible bacteria . Aim of study: To evaluate our management policy of chronic osteomylitis (C.O.M).
Methods : 32 patients presented with different types &forms of chronic osteomyelitis in many sites of long & flat bones such as tibia , femur, ,humerus ,iliac bones and knee joint , which are not response to previous

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