ABSTRACT
Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.
ABSTRACT
Objective: The objective was to identify the variables that affect the delinquency rate in banking and microfinance institutions, between the periods 2015 and 2020, for which panel data models were used, considering the information registered in the banking and financial institutions to the level of Peru. Method: The methodological design used is quantitative, not experimental, with a descriptive-correlational design, applying the analysis of the data panel for each financial institution (Multiple Banking, Municipal Savings Banks), to observe the behavior over time for the same individuals. Results: It was determined that the behavior of the delinquency of microfinance institutions is having significant effects on the delinquency of loans, and macroeconomic variables like microeconomic variables do determine delinquency rates such as provisions, efficiency of analysts, financial income, liquidity in national currency, growth rate of Gross Domestic Product, and the level of unemployment, both for banks and for municipal savings and credit banks, explaining the study variables in 84.30% in the banking system and in 48.95% in the financial system with respect to delinquency. Conclusions: Macroeconomic and microeconomic variables are determining factors for the level of delinquency in financial institutions.