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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
Mon Jul 03 2023
Journal Name
Journal Of Polymer & Composites
Metal Complexes of Cephalexin and Their Biological Activities: A Review
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Cephalexin and its derivatives are commonly utilized in the pharmaceutical and medicinal industry due to their biological and pharmaceutical activities, including anti-microbial, anti-cancer, anti-bacterial, and herbicidal activities as well as possessing high palatability and being useful for skin and joint infections. Interestingly, some organic drugs, including cephalexin, which exhibit toxicological and pharmacological properties, can be administered in forms of metal complexes. Many researchers have synthesized organic ligands derived from cephalexin in forms of Schiff bases and azo compounds which exhibited higher biological and medicinal properties when compared to cephalexin alone. One of the important features that make Schiff base

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Engineering
Study the Properties of Sodium Silicate Composite as a Barrier Separating Between the Internal Oil Distillation Towers and Chemical Fumes of Crude Oil
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The study of surface hardness, wear resistance, adhesion strength, electrochemical corrosion resistance and thermal conductivity of coatings composed from sodium silicate was prepared using graphite micro-size particles and carbon nano particles as fillers respectively of concentration of (1-5%), for the purpose of covering and protecting the oil distillation towers. The results showed that the sodium silicate coating reinforced with carbon nano-powder has higher resistance to stitches, mechanical wear, adhesive and thermal conductivity than graphite/sodium silicate composite especially when the ratio 5% and 1%, the electrochemical corrosion test confirmed that the coating process of stainless steel 304 lead to increasin

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Craniofacial Surgery
Evaluation of the Trephine Method in Harvesting Bone Graft From the Anterior Iliac Crest for Oral and Maxillofacial Reconstructive Surgery
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Publication Date
Sat Aug 01 2020
Journal Name
Microporous And Mesoporous Materials
Synthesis of hierarchically porous ZSM-5 zeolite by self-assembly induced by aging in the absence of seeding-assistance
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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Using Iterative Reweighting Algorithm and Genetic Algorithm to Calculate The Estimation of The Parameters Of The Maximum Likelihood of The Skew Normal Distribution
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Excessive skewness which occurs sometimes in the data is represented as an obstacle against normal distribution. So, recent studies have witnessed activity in studying the skew-normal distribution (SND) that matches the skewness data which is regarded as a special case of the normal distribution with additional skewness parameter (α), which gives more flexibility to the normal distribution. When estimating the parameters of (SND), we face the problem of the non-linear equation and by using the method of Maximum Likelihood estimation (ML) their solutions will be inaccurate and unreliable. To solve this problem, two methods can be used that are: the genetic algorithm (GA) and the iterative reweighting algorithm (IR) based on the M

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Publication Date
Mon Sep 29 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison of enamel color alteration between bonded and free unbonded surfaces of maxillary anterior teeth after fixed orthodontic therapy (A prospective clinical study)
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Background: The purpose of this study is to compare the color changes between the bonded middle third and the unbonded gingival and incisal thirds, fallowing fixed orthodontic treatment Material and method: The color parameter l, a, b has been recorded for each thirds in upper anterior teeth by mean of easy shad device. The has been calculated for gingival, middle and incisal thirds for the upper anterior teeth in 34 patient, 17 males and 17femals, those subject undergone fixed orthodontic treatment Results: The in middle bonded third is highly significant higher than that in incise and gingival thirds p<0.01 because the middle third isn’t expose to oral fluid and dental brushing since it covered by the bracket. Also there

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Publication Date
Sat Apr 08 2023
Journal Name
Iraqi Journal Of Oil And Gas Research (ijogr)
How to Estimate the Major Petrophysical Properties: A Review
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Publication Date
Thu Oct 12 2023
Journal Name
Mustansiriyah Journal Of Pure And Applied Sciences
Cavitation microbubbles in the medical ultrasound imaging: A Review
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Ultrasound is a mechanical energy which can generate altering zones of compression and rarefaction along its path in the tissues. Ultrasound imaging can provide a real time screening for blood and multiple organs to aiding the diagnostic and treatment. However, ultrasound has the potential to deposit energy in the blood and tissues causing bio effects which is depending on ultrasound characteristics that including frequency and the amount of intensity. These bio effects include either a stable cavitation presented non thermal effects or inertial cavitation of harmful effect on the tissues. The non-thermal cavitation can add features in diagnostic imaging and treatment more than the inertial cavitation. Ultrasound Contrast agents are a micro

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Publication Date
Tue Sep 03 2019
Journal Name
Rawal Medical Journal
Evaluation of Radial Nerve Injury Associated with Closed Humeral Shaft Fracture by Early Pre-operative Ultrasonic Evaluation and Correlation with Surgical Exploration
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Traumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas

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Publication Date
Thu Aug 31 2017
Journal Name
Journal Of Engineering
The Effect of Cyclic Bending Loads on Crack Growth in Pipes for Inclined and Transverse Cracks with or Without Internal Pulsing Pressure
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In the present research a new test rig has been proposed to be suitable for different cyclic loads such as cyclic bending, cyclic torsion, proportional and non proportional loads. In this work the efforts were concentrated on the cyclic bending loads concerning cracked pipes with or without internal pulsing pressure to study crack propagation in small bore pipes (up to 1'') for transverse or inclined cracks. The rig simulates the real service conditions under different stresses by means the least dangerous case will be suggested, so the experiments were considered for copper pipe, and the results have been tabulated and drawn to demonstrate the crack growth behavior as well as to justify the outcomes practically, consequently the durabil

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