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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
Sat May 16 2009
Journal Name
Journal Of Planner And Development
Support environmental programs using knowledge management
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The research deals with Environmental Management and how to develop its programs with the use of Knowledge Management, the environmental programs that integrate with processes can add strategic value to business through improving rates of resource utilization , efficiencies , reduce waste, use risk management, cut costs, avoid fines and reduce insurance. All these activities and processes can improve it through knowledge management, the optimal usage for all organizations information , employ it in high value and share it among all organizations members who involves in modify its strategy . Choosing suitable environmental management information system, develop it and modify it with organization processes, can greatly serve the en

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
TOTAL QUALITY MANAGEMENT IN EFL EDUCATION
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The purpose of this study is to identify the extent of the EFL teachers’ implementationoftotal quality management (TQM)principles through teaching English as a foreign language in Iraqi secondary schools.A total of 180 EFL teachers fromsecondary schools in Baghdad during the academic year 2010/ 2011 participated in the study. Data was collected using a scale to identify the extent of implementation of total quality management principles by 140 EFL teachers in their classroom. To support the data collected from the scale,40 teachers were observed by EFL educational supervisors during their lessons. The collected data was analyzed using frequency, means and standard deviation to identify the extent of implementation of (TQM) principles.

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Study on Safety Construction Management Plan
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After studying the reality of application to occupational safety in new Iraqi building projects and sampling the situation wilt that in developed and neighboring countries, researcher found that there is a big gap in the level of safety application conditions, this indicates the need fora quick and clear reference for local engineers to use it on site for safety conditions in their projects . As a case study the monitors work the researcher studied a huge project in the United Arab Emirates.This project considered for safety requirements to highest grades. This case study may be far away from the projects in Iraq, but we hope to rise the Iraqi work level in the near future. After seeing the way of administration work and how they were ra

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Development human capital Across practices management
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           The objective of this research is to study the effect of human capital dimensions (knowledge, skills, abilities, value) and his management dimensions (leadership practices, employess engagement, access knowledge, workforce optimization, learning capacity) with the Office of the Inspector General's staff - the Iraqi Ministry of Culture, has depended questionnaire as a tool in data and information related to research collection, as distributed to a sample of (63) individuals were distributed in positions (director, director of the Division of employees) the search data analysis using ready-statistical program (spss) the researcher used hypothesis testing and correlation c

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Publication Date
Sun Oct 12 2025
Journal Name
Al-fatih Journal
Development of explosive power training with weights in a way the ups and downs and its impact on the improvement of some variables Albyukinmetekih and technical performance of the skill of a leap forward on your hands vaulting modern
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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
The Effect of Sodium Selenite and Vitamin A on FSH and LH Level in Albino Male Mice treated with Hexavalent Chromium
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The present expermint was designed to determine the effect of Sodium Selenite (0.5 mg/kg) and Vitamin A (10 mg/kg) in FSH and LH level in Albino Male Mice treated with Hexavalent Chromium (1000 ppm). `This study included 48 mice divided into six groups (1st group treated with distilled water and the 2nd group treated with Sesame Oil were considered as control group, 3th group exposed to Hexavalent chromium , 4th group treated with Sodium Selenite and exposed to Hexavalent Chromium , 5th group treated with Vitamin A and exposed to Hexavalent Chromium and 6th group treated with Sodium Selenite and Vitamin A and exposed to Hexavalent Chromium ) . The treatment lasted for 35 days. The results showed a significant (P ? 0.05) decrease in FSH an

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Diversity of Morphological and Syntactic Aspects in the Holy Quran with Reference to the Verse "Have we not made the earth a receptacle"
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Diversity of the aspects of analyzing a specific linguistic issue is considered to be a
familiar phenomenon in learning Arabic in which – at different levels- various linguistic
aspects and phases – sometimes – are involved in a linguistic issue . In this paper , the
problematic issues during linguistic analysis are taken into an account. The Holy Quran
interpretation books include many Quranic expressions which have a lot of meaning described
by different interpreters , from them this paper has selected only one expression ( = كفاتا
receptacle ) from the verse "Have we not made the earth a receptacle " ( Al- Mursalat verse 25
) , this paper believes that this expression is sufficient display the interpret

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Publication Date
Sat Jan 12 2013
Journal Name
Pierb
RADAR SENSING FEATURING BICONICAL ANTENNA AND ENHANCED DELAY AND SUM ALGORITHM FOR EARLY-STAGE BREAST CANCER DETECTION
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A biconical antenna has been developed for ultra-wideband sensing. A wide impedance bandwidth of around 115% at bandwidth 3.73-14 GHz is achieved which shows that the proposed antenna exhibits a fairly sensitive sensor for microwave medical imaging applications. The sensor and instrumentation is used together with an improved version of delay and sum image reconstruction algorithm on both fatty and glandular breast phantoms. The relatively new imaging set-up provides robust reconstruction of complex permittivity profiles especially in glandular phantoms, producing results that are well matched to the geometries and composition of the tissues. Respectively, the signal-to-clutter and the signal-to-mean ratios of the improved method are consis

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Optimization and Prediction of Process Parameters in SPIF that Affecting on Surface Quality Using Simulated Annealing Algorithm
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Incremental sheet metal forming is a modern technique of sheet metal forming in which a uniform sheet is locally deformed during the progressive action of a forming tool. The tool movement is governed by a CNC milling machine. The tool locally deforms by this way the sheet with pure deformation stretching. In SPIF process, the research is concentrate on the development of predict models for estimate the product quality. Using simulated annealing algorithm (SAA), Surface quality in SPIF has been modeled. In the development of this predictive model, spindle speed, feed rate and step depth have been considered as model parameters. Maximum peak height (Rz) and Arithmetic mean surface roughness (Ra) are used as response parameter to assess th

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Publication Date
Mon Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Planning and implementation of the audit process by using the styles of time management and its impact on the quality of the audit process: Applied Research in the Federal Board of Supreme Audit
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Witnessing the global arena many changes in the political, economic, social, scientific and technological have left their mark on the world as a whole, these changes require necessarily Advancement of the profession of auditing, and improve their performance, especially after the mixer skepticism the health of approach and the method followed by a check in the major audit firms global view as for the external audit of an active role in providing services to members of the community in various sectors, were to be provide these services to the highest level of quality.To ensure the quality of the audit process to be a proper planning is based on a scientific basis to be the substrate a strong underlying different audit works, and if planni

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