Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




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"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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MD, DM (Clinical Pharmacology)
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Department of Pharmacology
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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
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Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
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The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2012 | Month : June | Volume : 6 | Issue : 5 | Page : 764 - 766

Length of the Anterior Cerebral Artery (ACA) on MRI Angiograms

Navita Aggarwal, Molly M. Paul, Madhumita Mukherjee, J.N. Toppo, Manjot Kaur, Gaurav Goel

1. Corresponding Author, 2. (Professor) Department of Anatomy, Christian Medical College (CMC), Ludhiana (Punjab), India. 3. Assistant Professor( Department of Anatomy) Christian Medical College, Ludhiana, (Punjab) India. 4. Professor and Head Department of Radiodiagnosis and Imaging Christian Medical College, Ludhiana, (Punjab) India. 5. Associate Professor, Department of Radiology Adesh Institute of Medical Sciences and Research, Bathinda, (Punjab), India. 6. M.B.B.S

Correspondence Address :
Dr. Navita Aggarwal, M.S. (Anatomy)
(Assistant Professor) Department of Anatomy
Adesh Institute of Medical Sciences and Research,
Bathinda, (Punjab) India.
Phone: +919855424777
E-mail: navita22a@gmail.com

Abstract

Magnetic Resonance Imaging, by far, has been found to be the most sensitive and non-invasive method for detecting angiographic images on the circle of Willis. The length of the vessels which form part of the circle of Willis is important for neurosurgeons while they perform various neurological procedures. It also helps the radiologists in interpreting the angiographic images in a better way. The length of the vessel also affects the haemodynamics of the vessel, thus affecting the major role of the circulus arteriosus as an anastomotic channel. Though many studies have been conducted on cadavers to measure the length of various cerebral vessels, not much work has been done on the length of the vessels by using modern techniques like MRI. The vessel length in the circle of Willis on MRI has not been reported, especially in this region of north India. This study was conducted on 120 normal angiographs which were taken by magnetic resonance angiographic techniques. In the results which were obtained in the present study, the length of the vessel was found to be higher on the left side. The range of the length on the right side was 10.4mm - 27.54mm, the mean length being 15.78mm ± 3.71mm, whereas on the left side, the range of the length was 10.6mm - 31.96mm and the mean length was 17.37mm ± 4.84mm . The present study gave the length of the anterior cerebral artery according to the side. In view of this, the length which is presented here may provide reference values which are specific to the three dimensional time of flight MRI angiography and it may be of value in the investigation of other pathologic features of the circle of Willis.

Keywords

Anterior Cerebral Artery, Length, Angiograms, MRI

How to cite this article :

Navita Aggarwal, Molly M. Paul, Madhumita Mukherjee, J.N. Toppo, Manjot Kaur, Gaurav Goel. LENGTH OF THE ANTERIOR CEREBRAL ARTERY (ACA) ON MRI ANGIOGRAMS. Journal of Clinical and Diagnostic Research [serial online] 2012 June [cited: 2019 Aug 23 ]; 6:764-766. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2012&month=June&volume=6&issue=5&page=764-766&id=2229

INTRODUCTION
The Anterior Cerebral Artery (ACA) on each side of the circle of Willis, is a branch of the internal carotid artery. The two ACAs complete the circle of Willis anteriorly through an anastomosis between them – the anterior communicating artery (A Com A.). The surgical nomenclature divides the vessels into three parts; A1 – from the termination of the internal carotid artery to the junction with the anterior communicating artery; A2 – from the junction with the anterior communicating artery to the origin of the callosomarginal artery; and A3 – distal to the origin of the callosomarginal artery. The A1 segment is also known as the pre-communicating part of the anterior cerebral artery (1). It is well known that MRI angiography is a sensitive and non-invasive modality which is suitable for detecting the anatomy of the circle of Willis. MRI angiography is said to have 100% sensitivity and 100% specificity for the anterior, middle and the posterior cerebral arteries. This modality is useful for finding a standard of reference for research on the anterior cerebral artery – the focus of the present study. The aim of the present study was to find out the variations in the length of the anterior cerebral artery in relation to the side in the living, on MRI angiograms.

Material and Methods

This study was conducted on 120 normal angiograms of adult patients who underwent the three dimensional time of flight Magnetic Resonance Angiography of the circle of Willis at 1.5 Tesla field strength scanners in the Department of Radiodiagnosis and Imaging at Christian Medical College, Ludhiana and at Adesh Institute of Medical Sciences And Research, Bathinda, India. All the angiograms were evaluated at the Radiology Department’s workstation, on its maximum intensity projections as well as its source images. The A1 segment of the anterior cerebral artery, which is one of the components of the circle of Willis, was studied for its length. The following two points were marked separately for ACA,
• at its origin from the internal carotid artery (taken as point ‘A’),
• at the proximal part of its junction with the anterior communicating artery (taken as point ‘B’).
Then, the lengths of the A1 segment of the anterior cerebral artery on the right and left sides were measured between the two points (point ‘A’ and ‘B’). Due to the course of the artery being tortuous with angulations, the length was measured in segments, which were then added and the total length was calculated. The projections which showed the anterior part of the circle of Willis with minimum overlapping were selected for taking measurements. The cases in which points ‘A’ and ‘B’ at which the measurements were to be taken were not clear, either because of overlapping in the projections or because of any other reasons, were not included. Also, the cases in which any of the projections could not make the entire course of the A1 anterior cerebral artery clear, were not included for the study.
MRI ANGIOGRAMS
Measurements of the length of the Anterior Cerebral Artery were taken on the right and left sides on the MRI angiograms.

Results

(Table/Fig 3) the length of the anterior cerebral artery (between points ‘A’ and ‘B’) in millimeters on the MRI angiograms on the right and left sides in a total of 120 cases. On comparison of the right and the left segments, the length was found to be more on the left side than on the right side. The difference of the length on the two sides was statistically non-significant. (Table/Fig 4) (Graph 1): Depicts the comparison of the right and left segments for the length of the anterior cerebral artery (Table/Fig 1),(Table/Fig 2),(Table/Fig 5).

Discussion

Various authors have measured the length of the A1 segment of the anterior cerebral artery on cadaveric brains and the values which have been given by them have been tabulated below in comparison to the values which were obtained in the present study which was conducted on MRI angiograms. Also, Saeed A et al, in 2011, by using public domain software, found the length of the A1 segment to be12.5 + /_ 2.2 mm (9). The lengths of the segments of each of vessels that compose the arterial pattern in the circle of Willis are also significant for the blood flow in it, besides the fact that this will determine the configuration of the system (10). The study of the length of the vessels is important because it has been verified that the non-linearity of the flow characteristics of the vessel segments, to a great extent, is caused by their tortuosity and small length, in relation to their diameter. The non-linear effects are particularly pronounced in the condition of the pathological occlusion of the supplying vessels (11). It has also been reported that the large asymmetries in the volume flow between the right and left sides is not necessarily caused by vascular diseases, but that they may be caused by the variation in the anatomy of the circle of Willis (12). The data of this study can provide precise micro-anatomic information for the surgical treatment of aneurysms or vascular reconstructive procedures in the circle of Willis (5). Also, the anatomic parameters of the anterior cerebral artery may be used to plan and design devices such as angiographic micro catheters and guides which are used in endovascular procedures (13). An idea of the normal dimensions of this vessel may contribute greatly to the surgeons’ assessment of the feasibility of ‘shunt operations’. Also, it must be emphasized that a wider range of information on the size of the considered artery may be useful for a better interpretation of the angiographic images and for a deeper understanding of the cerebral pathology (4). Thus, recognizing the variations of the anterior cerebral artery during the interpretations of cranial angiograms is extremely important (14). Several factors can account for the variation in these results. Firstly, the selected study populations differ (the vessels in the normal brains, as compared to the vessels in the brains with evidence of neurovascular disease). Secondly, the methods and techniques of the examination differ (anatomic dissection vs conventional contrast material enhanced angiography vs phase contrast or time of flight angiography). Thirdly, the investigators use a set of criteria to define a normal or complete circle of Willis. The specific condition of a selective patient population may also contribute to the variability. Although the time of the flight MRI angiography has demonstrated a high sensitivity for the detection of the circle of Willis vessels, the technique does have its limitations, such as difficulties in depicting the small vessels with slow or turbulent flow. The signal intensity of blood flow within a vessel is dependent on the replenishment of fully magnetized spins as they enter the imaging section for a maximum flow effect in the time of flight MRI angiography. The sensitivity of the three dimensional time of flight MRI angiography for the detection of small communicating vessels, improves with the flow through these vessels, as the flow velocity improves the signal intensity. Non-visualization of the vessels on the time of flight MRI angiograms can be due to any slow or negligible flow within a patent vessel or due to the true absence of the vessel (15). The present study gives the length of the anterior cerebral artery and its difference according to side and sex. In view of this, the length which has been presented here may provide reference values which are specific to the three dimensional time of flight MRI angiography and it may be of value in studies in which the threedimensional time of flight MRI angiography is used to investigate other pathologic features of the circle of Willis.

Acknowledgement

Acknowledge with deep gratitude the people in the department of Radiology and in department of Anatomy, Adesh institute of medical science and Research (AIMSR), Bathinda. for their suggestions and support rendered to me in completion of this work. My special thanks to Mr. Anil for his help with statistical compilation of the study. I would like to thank Miss. Pavitra and Mr. Ashwani, the MRI technicians for the long hours that they devoted for helping me in the data collection for this study.

References

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Standring S. Development of the nervous system. In: Standring S, Ellis H, Healy JC, Johnson D, Williams A, Collins P, et al editors. Gray’s Anatomy, The Anatomical Basis Of Clinical Practice. 39th ed. Elsevier Churchill Livingstone; 2005; 241-74.
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Murray KD. Dimensions of the circle of Willis and dynamic studies which were done by using electrical analogy. J Neurosurg. 1964;21:26-34.
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Kamath S. Observations on the length and diameter of the vessels which form the circle of Willis. J Anat.1981;133:419-23.
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Orlandini GE, Ruggiero C, Orlandini SZ, Gulisano M. Blood vessel size of the circulus arteriosus cerebri (circle of Willis). A statistical research on 100 human subjects. Acta Anat.1985;123:72-6.
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Gomes FB, Dujovny M, Umansky F, Berman SK, Diaz FG, Ausman JI. Micro-anatomy of the anterior cerebral artery. Surg Neurol. 1986; 26:129-41.
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Pai SB, Kulkarni RN, Varma RG. Micro-surgical anatomy of the anterior cerebral artery-the anterior communicating artery complex: An Indian study. Neurology Asia. 2005;10:21-28.
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Mandiola E, Alarcon E, Onate JC, Sanhueza P, Sol M, Olave E. Biometrical aspects of the anterior cerebral artery in its proximal segment (A1) and in the internal carotid artery. Int J Morphol 2007;25:915-18.
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Krishnamurthy A, Nayak SR, Bagoji IB, D’Costa S, Pai MM, Jiji PJ, et al. Morphometry of the A1 segment of the anterior cerebral artery and its clinical importance. Clin Ter. 2010; 161(3):231-4.
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Saeed A, Majid D , Behzad E, Douglas J. M, Sarah G, Hassan A. et al. A simple technique for the morphological measurement of the cerebral arterial circle variations by using public domain software (Osiris). Anat Cell Biol. 2011; 44(4): 324–30.
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Pallie, W. A study on the quantification of the circle of Willis. Brain.1962; 85(3): 569-78.
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Cieslicki K, Ciesla D. Investigations on the flow and pressure distributions in the physical model of the circle of Willis. J Biomech. 2005;38:2302-10.
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Hendrikse J, Van Raamt AF, van der Graaf Y, Mali WP, van der Grond J. Distribution of the cerebral blood flow in the circle of Willis. Radiology. 2005;235:184-89.
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Stefani MA, Schneider FL, Marrone ACH, Severino AG, Jackowski AP, Wallace MC. Anatomic variations of the anterior cerebral artery’s cortical branches. Clin Anat. 2000;13:231-36.
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Uchino A, Nomiyama K, Takase Y, Kudo S. Anterior cerebral artery variations which were detected by MR angiography. Neuroradiology. 2006;48:647-52.
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Hartkamp K, Grond JV, Leeuw FE, Groot JC, Algra A, Hillen B. Circle of Willis: Morphologic variation on the three-dimensional time-of-flight MR angiograms. Radiology. 1998; 207:103-11.

DOI and Others

Financial OR OTHER COMPETING INTERESTS:
None.
Date of Submission: Feb 03, 2012
Date of Peer Review: Mar 26, 2012
Date of Acceptance: May 05, 2012
Date of Publishing: Jun 22, 2012

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  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com