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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 Dec 31 2015
Journal Name
International Visible Conference On Educational Studies & Applied Linguistics 2016
A New Perspective About Masculinity and the Issue of Identity in Ernest Hemingway's The Old Man and The Sea and Michael Ondaatje's in The Skin of a lion
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A New Perspective About Masculinity and the Issue of Identity in Ernest Hemingway's The Old Man and The Sea and Michael Ondaatje's in The Skin of a lion

Publication Date
Thu Mar 13 2025
Journal Name
Corporate And Business Strategy Review
An empirical examination of working capital management strategy in paper manufacturing companies
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This work is licensed under a Creative Commons Attribution 4.0 International License. Abstract This study examines the working capital management

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of Diabetes type 2 Clients’ Self-Management Skills toward Dietary Pattern
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Objective: study aims to identify the diabetes type2 clients self management skills toward dietary pattern
, and find out the relationship between variables which are (Age, gender, educational level, duration of DM
diagnosis, and monthly income) with diabetes type 2 clients self management skills toward dietary pattern
Methodology: descriptive study was carried out through the present investigation from January 2nd
2011to September 2nd 2011 in order to achieve the objectives of the present study. A non probability
(purposive) sample, (200) cases which consists of clients who were attending Al-Nasiriyha diabetic center.
Including (118) males and (82) females. The data were collected by utilization of the study instrument

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Extra-Anatomic prosthetic bypass grafts in management of Sub-inguinal vascular infections
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Infection at the site of vascular anastomosis is a serious complication of vascular surgery and is associated with a high limb loss and mortality rate. The classical method of management is ligation of the injured artery, adequate wound debridement and restoration of circulation. The latter is achieved by either in situ or extra-anatomic bypass. If the distal circulation is not maintained, subsequent amputation is most likely.
Objectives: In this study we tried to assess the efficacy of extra-anatomic synthetic bypass grafts in the treatment of vascular infection in the groin to save the limb and avoid the inevitable amputation.
Methods: Between January 2006 and December 2007, ten male patients aged twenty to thirty five years (mea

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Publication Date
Thu Jan 07 2021
Journal Name
Journal Of Craniofacial Surgery
Management of Maxillofacial Trauma in Attempt Suicide Patients During COVID-19 Pandemic
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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Artificial Accelerated Aging on The Color of Ceramic Veneers Cemented With Different Resin Cements (A Comparative In Vitro Study)
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ABSTRACT Background: Color changes that are detectable to human eye can affect the esthetic appearance of ceramic veneers. The purpose of this study was to evaluate and compare the effect of artificial accelerated aging on the color of ceramic veneers cemented with different resin cements. Materials and Methods: Sixty discs were prepared with 0.5 mm thickness, 30 discs made from IPS e.max press (Ivoclar Vivadent) and 30 discs were made from VITA Enamic (VITA Zahnfabrik). The discs were cemented with three resin cements: Variolink Veneer MV 0 shade (Ivoclar Vivadent), Rely X veneer Translucent shade (3M ESPE) and NX3 Nexus Clear shade (Kerr Corporation) with 0.1 mm thickness. The spectrophotometer Easyshade Advance was used to measure the co

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Review of Histopathological Diagnoses of One Year Appendectomy Specimens in Sulaimani City
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Objective: To review and see the pattern of histopathological diagnoses of one year appendectomy specimens.
Methodology: This retrospective study was carried in Sulaimani Teaching Hospital over the period of one year (from 1st
of January to 31st of December 2009). All pathological reports were reviewed retrospectively for patient’s age, sex,
histopathological diagnosis and operative findings (if present). Histopathological diagnoses then were classified into
either positive or negative for acute inflammation. Any associated findings or any surgical specimen removed with the
appendix was recorded. The obtained data were analyzed by using the statistical package social sciences (SPSS) version
19; with Chi square to test

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Publication Date
Mon Jul 01 2013
Journal Name
International Journal Of Computer Applications
Mixed Convection in a Square Cavity Filled with Porous Medium with Heated Bottom Wall
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Two-dimensional unsteady mixed convection in a porous cavity with heated bottom wall is numerically studied in the present paper. The forced flow conditions are imposed by providing a hydrostatic pressure head at the inlet port that is located at the bottom of one of the vertical side walls and an open vent at the top of the other vertical side wall. The Darcy model is adopted to model the fluid flow in the porous medium and the combination effects of hydrostatic pressure head and the heat flux quantity parameters are carefully investigated. These governing parameters are varied over wide ranges and their effect on the heat transfer characteristics is studied in detail. It is found that the time required to reach a desired temperature at th

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Publication Date
Sun May 22 2022
Journal Name
International Journal Of Early Childhood Special Education
A training program based on integrating futuristic thinking skills with classroom interaction patterns and its effect on the academic self- efficacy of mathematics teachers
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The research aims to identify the effect of the training program that is based on integrating futuristic thinking skills with classroom interaction patterns on mathematics teachers in order to provide their students with creative solution skills. The research sample consisted of 31teachers (15 teachers for the experimental group and 16 for the control groups). The researcher developed a measure for the academic self-efficacy consisting of (39) items. Its validity, reliability, coefficient of difficulty and discriminatory power were estimated. To analyze the findings, the researcher adopted the Mann-Whitney (U) test and the effect size, and the findings were as follows: There is a statistically significant difference at the significance leve

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Publication Date
Fri May 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of tongue space area in a sample of Iraqi adults with class I dental and skeletal pattern
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Background: Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. This study aimed to determine the tongue and surrounding space area in a sample of Iraqi adults with class I dental and skeletal pattern. Materials and methods: The study included thirty healthy subjects (15 males and 15 females) with an age ranged between 23-34 years and class I dental and skeletal pattern with no history of any sleep related disorders. The assessed cephalometric measurement included length and height of the tongue and position of hyoid bone from cervical line. Descriptive statistics were obtained for the data. Genders difference was evaluated by independent sample t-test. Results: There wer

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