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dominates modern treatment strategies Unfortunately there appears to be no way of determining reliably which patients will bleed again The cause of recurrent bleeding is not understood but may be related to naturally occurring mechanisms of clot formation and lysis at the site of initial rupture, usually at the dome of the aneurysm Patients with the typical clinical picture of spontaneous subarachnoid hemorrhage in whom an aneurysm or arteriovenous malformation cannot be demonstrated angiographically have a distinctly better prognosis than those in whom the lesion is visualized (Nishioka et al) In a series of 323 angiographically negative cases followed for an average of 10 years, there was rebleeding in only 12 (Hawkins et al) After 22 years, 69 percent of these patients had survived It is customary in most centers to repeat the arteriogram in several weeks, because it has been observed that vascular spasm may have earlier obscured the aneurysm It is advantageous to obtain x-rays from several different angles in order to expose those views that were obscured by adjacent overlying vessels If the rst study involves all cerebral vessels and utilizes several views of the basal circulation, it has been our experience that the second arteriogram is infrequently more revealing but our practice is to repeat it nonetheless Another clinical circumstance with a favorable outcome is limited perimesencephalic hemorrhage, described by van Gijn and colleagues The cisterns surrounding the midbrain and upper pons are symmetrically lled with blood, the headache is mild, and signs of vasospasm do not develop No aneurysm is found at the expected site for blood in this region, ie, at the top of the basilar artery The patient usually does well and a second arteriogram is probably not required It has been speculated that the bleeding has a venous rather than an aneurysmal source As regards prognosis of aneurysmal hemorrhage, McKissock and colleagues decades ago found that the patient s state of consciousness at the time of arteriography was the single best index of outcome, and this remains true today Their data, representative of the status of aneurysm management in the 1950s and consonant with the natural history before the advent of modern surgical and intensive care techniques, indicated that of every 100 patients reaching a hospital and coming to arteriography, 17 were stuporous or comatose and 83 appeared to be recovering from the ictus At.

This information is useful if you want to modify process groups or send the parent process a signal Under Unix, your parent process ID should be greater than 1; a parent process ID of 1 indicates that the parent has died and that you ve been adopted by the init process

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Figure 34-24 Berry aneurysm of the anterior communicating aneurysm A Magetic resonance angiogram; B CT angiography showing the anuerysm in relation to the adjacent bony and vascular structures

A collection of processes is logically grouped into process groups For example, all the programs run within a shell belong to the same process group, providing they don t

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elect to change the process group You can obtain the process group of a process using the getpgrp function: