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Morphological Study of Pterion in Skulls of Corpses of the Institute of Legal Medicine and Forensic Sciences (Ditanfor), Lima - Peru 2018

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Morphological Study of Pterion in Skulls of Corpses of the Institute of Legal Medicine and Forensic Sciences (Ditanfor), Lima - Peru 2018 Rev Mex Med Forense, 2019, 4(2):12-23 ISSN: 2448-8011 Morphological study of Pterion in skulls of corpses of the Institute of Legal Medicine and Forensic Sciences (Ditanfor), Lima - Peru 2018 Original Article Murrieta-Angulo, Shirley 1, Tejada-Valdivia, César Andrés 1, Arriola-Guillén, Luis Ernesto 1 Received: November 15, 2018, Accepted: January 15, 2019, Published: May 15, 2019 1 Scientific University of the South, Division of Thanatology, Institute of Legal Medicine and Forensic Sciences, Academic Department of Professional Career in Stomatology, Lima, Peru. Corresponding author: Shirley Murrieta Angulo, [email protected] SUMMARY in the neurological field, as well as in the forensic field and legal medicine due to its Introduction: Pterion is a craniometric morphological differences existing in point of sutural confluence, observable certain groups of individuals. The present from a lateral view of the skull; it study seeks to establish similarity criteria represents a point of reference and access Murrieta S, Tejada CA, Arriola LE. Rev Mex Med Forense, 2018, 4(2):12-23 between the most prevalent morphology during the necropsy of Law to each one of within the Lima, Peru population. them. Methods: 90 adult skulls were examined Results: The types of pterion were bilaterally including both pterion points; identified according to the classification of photographs of both areas were taken, Murphy, 1956; finding the types: looking for determinaning the most sphenoparietal (70%), frontotemporal prevalent morphology within the study (24%), starry (6%) and epipheric in none sample;, the average distances between of the cases. It was recorded that the the ossification center of the pterion and average distance is 40 mm for all cases. the posterior edge of the zygomatic arch Conclusions. The results obtained in the were obtained. The sample was constituted sutural morphology of the pterion and the by the skulls of the corpses arrived at the results of the measurements are of Institute of Forensic Medicine and importance for the neurosurgical Forensic Sciences DITANFOR of Lima, approach of the skull, registration in legal Peru in the period of September - medicine, forensic odontologic as well as November of 2018, using an inclusion anthropological studies. criterion of being only skulls of male Key words: Pterion, morphometry, suture, cadavers of ages between 25 at 75 years, corpses, forensic identification. the photographic images were obtained INTRODUCTION zygomatic bones; while in the catarrhines it is composed of the frontal, sphenoid, Pterion is a craniometric point that parietal and temporal bones [4]. These is located bilaterally; represents the sutural were the fundamental differences between confluence of four cranial bones: frontal, the morphologies of pterions of the first parietal, sphenoid and temporal; it is primates of the New World (platirrinos) visible from a side view of the skull [1]. In and the Old World (catarrhinos); this general, pterion is located two fingers allows to compare it with the morphology above the zygomatic arch, with a width of of current human beings, in order to have the thumb at its back to the frontal process an evolutionary record of the morphology of the zygomatic bone [2]. The of the pterion in current human beings; this morphology of pterion was studied for the would facilitate identification in an first time by Broca in 1875; it was investigation within the forensic field, as classified into three types: sphenoparietal, well as in the clinical setting during an frontotemporal and stellate. Sequentially, intervention of surgical approach in Murphy in 1956 classified them into four neurology. types: sphenoparietal, frontotemporal, stellate and epipheric [3]. This is the case of Natekar's study, which attributes the importance for These studies on morphology were surgeons and radiologists of this essential of great importance in terms of the information, before and during a surgical coincidental relationship in families of intervention [5]; it highlights the location primate individuals of the new world; in of its anatomical site, since it is very close the platyrrinos the pterion is composed of to the middle meningeal artery and on the the frontal, sphenoid, parietal and left side, to the motor area of Broca's Murrieta S, Tejada CA, Arriola LE. Rev Mex Med Forense, 2018, 4(2):12-23 speech, a decisive implication when 76.5% [11]. It must be taken into account proceeding to perform surgical approaches that the type of pterion is not always the of the anterior and middle cranial fossae same on the right and left sides, but there [6]. The investigation of the morphology was a 77% coincidence in this type of of the pterion was followed from the pterion [12]. In all the studies, it was observations of Broca and Murphy, who established that the skulls are of normal divided them into two trajectories with characteristics, without obvious evidence respect to the nature of the pterion. The of dystrophy, deformities and trauma, due initial studies were exploratory and to rupture or fusion of adjacent bones descriptive, in which patterns of (synostosis) [13]. Sex was also taken into articulation in pterion in humans and account in studies of interparietal bones primates were identified [7]. since they were observed in two male skulls and a female skull (0.99%) [14]; the In Murphy's study, it was revealed difference was not specific, so sex is that there are four types of pterion: excluded in this work to have accurate and sphenoparietal, frontotemporal, stellate comparable data. Regarding the presence and epipheric [8]. The epiderid bones of metopism, ossicles in the skull and (wormianos) are small and irregular, sutural abnormalities, this may be formed due to additional centers of associated with other cranial deformities ossification near the sutures lambdoidea, and justifies a meticulous clinical pterión and asterión. These Wormian approach that should not be forgotten in bones, epipteric or also called Inca bones, order to identify the differences between a are markers of various diseases, being current human being and an old one [15]. important in the primary diagnosis of The presence of the sutural bone in the osteogenesis imperfecta, and of bregma may be due to the appearance of neurocranial variables that can be an abnormal ossification center [16], deceptive in the diagnosis of fractures [9]. linked to the prehispanic cultures of humans of that time; makes clear the To study the morphologies of the differences between the bilateral pterion, we must take into account the symmetry of the lines that form the current studies such as those of Praba and pterions [17]. Venkatramaniah in 2012, in which they describe that the variants regarding the The study of the Pterion currently types of pterion are due to some factors continues to have a significant importance such as sex, age, ethnicity and the state in since it is a craniometric point that is which the skull is examined; these related to several structures in the cranial variations usually appear in relation to the cavity, such as the anterior branch of the way in which the bones come together and middle meningeal artery, the Broca area, form the region of the pterion. Praba and the insula and the stem of the lateral Venkatramaniah classify the pterions in groove. [18]; its location and frequency is frontotemporal, sphenoparietal, epipheric the basis for surgical interventions; there and stellate [10]. are ancient studies, such as the case of Murphy's original work, in which they On the other hand, a more recent worked with 400 Australian aborigine study in human skulls reveals that the most skulls to establish location and the 4 types common form of the pterion is that of a of pterion, taking into account their sphenoparietal joint, with an incidence of provenance and purity of race [19]. To Murrieta S, Tejada CA, Arriola LE. Rev Mex Med Forense, 2018, 4(2):12-23 complement these studies it is explained Public Ministry of Lima, Peru, with which that the sutural obliteration is involved in the university maintains an agreement and the location; it is assumed that there is a therefore no ethical vulnerability exists. genetic predisposition (genes that allow Likewise, it should be noted that the the formation of secondary ossification personal data of the corpses were not centers) and that Wormian bones are under identified; these counted with the direct genetic control regardless of the permission granted by the Institute of presence or absence of detectable cultural Legal Medicine and Forensic Sciences; deformation [20]. confidentiality was assured with the management of the results, which gave METHODS evidence of the total sample taking under the supervision of a forensic specialist. The study sample consisted of 90 corpses of cadavers that entered the The 90 skulls were evaluated Institute of Legal Medicine and Forensic bilaterally (180 sides); to demonstrate the Sciences, each of which presented as data, results, a photographic record was taken. their background and RENIEC record Data for each evaluated side were (National Identity Registry); for compiled in a data collection form classification purposes, sex, age and place designed by the researcher with the of origin were taken into account; these approval of the advisor. For each case, the data were taken under criteria of most prevalent morphology of the pterion confidentiality and anonymity for each was identified for each side in the skulls of corpse, not having to request an informed the corpses, using the classification of consent from the family member, since the Murphy (1956); the degree of sutural corpse, upon being admitted to the obliteration at the level of the bones that Institute of Thanatology, is under the make up the pterion was also classified, responsibility of the state; there was no using the System of the ectocranial data vulnerability or human integrity. obliteration of sutures according to Meindl & Lovejoy (1985) and White (2000), as After having passed the reviews by well as the average distance of the the established adviser and jury and after ossification center of the pterion.
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