DOCSLIB.ORG

Real-Time Sonographic Sector Scanning of the Neonatal Cranium: Technique and Normal Anatomy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Real-Time Sonographic Sector Scanning of the Neonatal Cranium: Technique and Normal Anatomy 349 Real-Time Sonographic Sector Scanning of the Neonatal Cranium: Technique and Normal Anatomy William P. Shuman 1 A commercially available wide field of view real-time mechanical sector scanner can James V. Rogers1 be used t o image the neonatal cranium. Because of the small transducer head size, the 1 Laurence A. Mack . 2 open anterior fontanelle can function as an acoustic window. By thus avoiding bone, higher f requency transducers may be used to improve image resolution. Infants may Ellsworth C. Alvord, Jr 3 be scanned quickly without sedation in their isolettes in the neonatal intensive care David P. Christie2 unit. Sterility of the infant environment is maintained by placing the transducer in a surgical glove. Using this technique, detailed normal anatomy can be seen such as vascular structures, caudate nucleus, thalamus, third ventricle, cavum septum pelluci­ dum, and the thalamocaudate notch. Angled coronal and sagittal sonographic anatomy is correlated with neonatal cadaver brain sections sliced in similar planes centered on the anterior fontanelle. The mechanical sector scanner has advantages over other real-time devices including improved image resolution, a wider field of view, and a small er area of transducer skin contact. These unique assets are particularly appli cable to th e evaluati on of the neonatal cranium. The small transducer of a sector scanner can easil y be held in contact with the open anterior fontanell e using it as an acousti c window. This window avoids bone and makes possible the use of a higher frequency transducer resulting in improved resolution. We report our technique for neonatal crani al sonography usin g a mechanical sector scanner. Norm al intracranial anatomy seen in angled coronal and sagittal planes is presented along with correlating neonatal cadaver specimens. Materials and Methods Seventy-two neonates who were clinicall y suspect for intracran ial hemorrhage were examined in their incubators in the neonatal intensive care unit (N ICU) usin g a mechanical sector scanner (ATL Mark III Imaging System). This has three internall y focused 5 MHz transducers positioned on a rotating element. Each transducer is acti vated through th e Receive d October 16, 1980; accepted aft er same 90 0 arc producing 18 to 45 im ages/ sec. The tran sducer skin contact area is 1.5 x revision January 15, 1981 1.5 cm. Images are generated in a circul ar sector format producing a pie-shaped field of , Department of Radiotogy, University Hospitat, view with the narrow, sli ghtly truncated end representing th e small area of skin contact (fig. SB-05, University of Washington, Seattte, WA 1). Images are processed through a real-time digital scan converter and projected on a 98185. video display system. A freeze frame mode is avail able so that video im ages may be 2 Department of Radiology, Harborview Medi­ recorded on 70 mm film. cal Center, ZA-65, 325 Ninth Ave., Seattle, WA In the NICU , the real-time sonographic unit is positioned beside th e infant incubator. It is 98104. Address reprint requests to L. A. Mack. not necessary to move the incubator or adjacent support eq uipment or to disturb the 3 Department of Pathology, Universi ty Hospital, oxygen and temperature controll ed environm ent. A small amount of aqueous acousti c RJ -05, Un iversity of Washington, Seattle, WA 98195. coupling gel is placed in the thumb of a steril e size 8 latex surgical glove. The transducer head is inserted into the thumb of the glove whic h then serves as a sterile barri er (fig . 2). This article appears in th e July/ August 1981 AJNR and October 1981 AJR. A small amount of acousti c gel is appli ed to the an teri or fontanell e. The glove-encased transducer is passed through th e port of the incubator and placed on th e anteri or fontanelle AJNR 2:349-356, July / AU9ust 1981 0 195-6 108 / 8 1/ 0204-0349 $00.00 in the coronal plane (fi gs. 3 and 4). By rocking the tran sd ucer back and forth , th e ve ntricul ar © Am erican Roentgen Ray Society system as well as peri ven tricul ar struc tures can be examined (fig. 5). Freeze-frame images 350 SHUMAN ET AL. AJNR:2, July/ Augusl 1981 Fig . 3 .- Transducer head is placed on anterior fontanell e and rocked back and forth to sweep sonographic beam through cerebral tissue. Fig. 1.-End-on frontal diagram of hand-held unit. The three transducers ro tate in a complete circ le but are acti vated through only a 90° arc produc ing a seclor image which widens as it deepens. Area of skin contact is small. angles relative to the canthomeatal li ne as diagrammed in figure 5. These cuts were designed to be parall el to th e sonographic beam and show the same anatomy as th e clinical sonog rams in figures 7 A, SA, 9A, 1 OA, and 11 A. A second brain from a simi lar infant was sli ced in fi ve sagittal planes centered on the anteri or fontanell e, as seen in figure 6. The placement of th ese cuts was designed to be parall el to the sonographic beam and show the same anatomy as figures 1 2A, 13A, and 14A. Results and Observations Coronal Sections Figure 7: coronal image with th e transducer placed on the anteri or fontanell e so th at th e sonographi c beam is angled 80° relati ve to the canth omeatal line (fig. 5 , plane 1). The plane of section includes the hypoechoic slitlike frontal horns of the lateral ventricles (5) and th e fluid-filled cavum Fig . 2 .-Hand-held unit is placed in surgical glove to maintain steri li ty. of the septum pellucidum (6), which li es between the frontal Transducer head fi ts into thumb o f glove. horns and is a normal structure in preterm infants. The relatively echoic heads of the caudate nuclei (7) lie inferi or to the lateral parts of th e frontal horns. Also well seen are are record ed at the level of the anteri or part of the frontal horns, the the bony landmarks, which inc lude the anterior clinoids (1 0) caudate nu clei in th e pl ane of the middle cerebral arteries, the th ird and the floor of the middle cranial fossa (12). The paren­ ventricle, the midbody of th e thalamus, and the atria of the lateral c hyma of the temporal lobes (11) and frontal lobes (3) has ventricles in the region of th e c horoid plexus. The transducer is th en turned 90° into the sagittal plane and rocked in a similar a low echogenicity relative to the caudate nuclei. Specific fashion (figs. 4 and 6). Sagittal freeze-frame images are recorded gyri such as the gyrus rectus (8) and c ingulate gyrus (1) at the midli ne as well as at the level of both caudate nuc lei and the can be identified by the echogenic subarachnoid c isterns lateral parts of both lateral ventricles. th at outline their boundaries. Vascular anatomy demon­ Anatomic-pathologic correlati on with sonograms was obtained strated includes the pericallosal artery (2) and the middle by cutting two neonatal brains in pl anes parall el to the pl anes of th e cerebral arteries (9) in the sylvian fissure (13). These arterial sonographic images generated through th e anteri or fontanelle. Th e structures are identified by their pulsations as well as their first brain specimen was from a term infant whose death 1 week location. aft er deli very was attributed to sudden infant death syndrome. At Figure 8: coronal secti on 70° to th e canthomeatal line autopsy the locati on of the anteri or fontanell e was marked on the (fig. 5 , pl ane 2) with th e transd ucer on th e anteri or fontanell e superi or su rface of th e brain . Tile brain was then removed from the skull and scanned in a water bath to in sure that it was sonographi­ angled 10° posteri or to fi gure 7 A. This secti on in c ludes the call y normal. Next, the brain was sliced five times in the coronal lateral ventricles (5), the foramina of Monro (1 4), the th ird plane with the superior part of each slice beginning just below the ventricle (15), and the parahippocampal gyrus (16). The anterior fontanelle. The slices extended inferiorly in five different bony landmarks of the greater wing of the sphenoid (17) AJNR:2, July / August 1981 SECTOR SCANNING OF NEONATAL CRANIUM 351 "­\ .Hl1e!lor ionlanel / Ci.IVUfll ~l'I)\um (hlld 1 pelluc'du m vent ,.ele 4 5 6 Fi g. 4 .- lmaging is centered on anterior fontanell e in both coronal and Fig. 6 .- Transducer is turned 90° and rocked on th e anteri or fontanell e sagittal planes. so that angled sag ittal im ages may be recorded of midline and two lateral Fig . 5.- Transducer is rocked on anteri or fontanell e so that angled coronal levels on eac h side; neonatal cadaver brai n was sli ced in these sa me planes im ages may be recorded at five different levels; neonatal cadaver brain was (see figs. 12-1 4). sliced in these same planes (see figs. 7 -11 ). and the floor of the middle cranial fossa (12) are dense of this section inc ludes the lateral ventri cles (5), th e thala­ bands of linear echoes defining the inferior extent of th e mus (22), th e quadrigeminal cistern (23), and the cerebell ar cranium.
Load more

Recommended publications
  • Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations
    ORIGINAL RESEARCH INTERVENTIONAL Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations Z.-S. Shi, J. Ziegler, L. Feng, N.R. Gonzalez, S. Tateshima, R. Jahan, N.A. Martin, F. Vin˜uela, and G.R. Duckwiler ABSTRACT BACKGROUND AND PURPOSE: DAVFs rarely involve the sphenoid wings and middle cranial fossa. We characterize the angiographic findings, treatment, and outcome of DAVFs within the sphenoid wings. MATERIALS AND METHODS: We reviewed the clinical and radiologic data of 11 patients with DAVFs within the sphenoid wing that were treated with an endovascular or with a combined endovascular and surgical approach. RESULTS: Nine patients presented with ocular symptoms and 1 patient had a temporal parenchymal hematoma. Angiograms showed that 5 DAVFs were located on the lesser wing of sphenoid bone, whereas the other 6 were on the greater wing of the sphenoid bone. Multiple branches of the ICA and ECA supplied the lesions in 7 patients. Four patients had cortical venous reflux and 7 patients had varices. Eight patients were treated with transarterial embolization using liquid embolic agents, while 3 patients were treated with transvenous embo- lization with coils or in combination with Onyx. Surgical disconnection of the cortical veins was performed in 2 patients with incompletely occluded DAVFs. Anatomic cure was achieved in all patients. Eight patients had angiographic and clinical follow-up and none had recurrence of their lesions. CONCLUSIONS: DAVFs may occur within the dura of the sphenoid wings and may often have a presentation similar to cavernous sinus DAVFs, but because of potential associations with the cerebral venous system, may pose a risk for intracranial hemorrhage.
    [Show full text]
  • MR Imaging of the Orbital Apex
    J Korean Radiol Soc 2000;4 :26 9-0 6 1 6 MR Imaging of the Orbital Apex: An a to m y and Pat h o l o g y 1 Ho Kyu Lee, M.D., Chang Jin Kim, M.D.2, Hyosook Ahn, M.D.3, Ji Hoon Shin, M.D., Choong Gon Choi, M.D., Dae Chul Suh, M.D. The apex of the orbit is basically formed by the optic canal, the superior orbital fis- su r e , and their contents. Space-occupying lesions in this area can result in clinical d- eficits caused by compression of the optic nerve or extraocular muscles. Even vas c u l a r changes in the cavernous sinus can produce a direct mass effect and affect the orbit ap e x. When pathologic changes in this region is suspected, contrast-enhanced MR imaging with fat saturation is very useful. According to the anatomic regions from which the lesions arise, they can be classi- fied as belonging to one of five groups; lesions of the optic nerve-sheath complex, of the conal and intraconal spaces, of the extraconal space and bony orbit, of the cav- ernous sinus or diffuse. The characteristic MR findings of various orbital lesions will be described in this paper. Index words : Orbit, diseases Orbit, MR The apex of the orbit is a complex region which con- tains many nerves, vessels, soft tissues, and bony struc- Anatomy of the orbital apex tures such as the superior orbital fissure and the optic canal (1-3), and is likely to be involved in various dis- The orbital apex region consists of the optic nerve- eases (3).
    [Show full text]
  • Comparison of the Newborn Skull to the Adult Human Skull
    Comparison of the Newborn skull to the Adult Human Skull As a baby grows older their skull goes through a huge change. The neurocranium starts off not as hard as it will be, gaining the ability to shape in whatever way is needed. While their facial cranium, their face, begins to take on unique qualities and changes to look like a mature adult skull. This process takes time but all the changes are very visible. The neurocranium compared to an adult’s is more oval and is substantially bigger than the facial cranium. The newborn's skull has four “horns” two in the front on the frontal bone and two in the back on the parietal bone. These bumps are the thickness that the skull will eventually become. The edges are ridged in between the frontal and the parietal. On top of the skull is the anterior fontanel, which is an opening in the skull that is small and shaped like a diamond. This will close when the child is around two years old. Coming out of the points from the anterior fontanelle are lines or spaces in between the bones, some of these overlap. The advantage of both the spaces in between the bones and the anterior fontanel is room for growth and compression through the birth canal. As a newborn, their neurocranium is 60% of the circumference of an adult’s. At two to three it is 90% of an adult’s, so most of the growth of the neurocranium happens before the child is three. The adult’s skull is more circular and the nose, eyes, and mouth are father apart.
    [Show full text]
  • Morfofunctional Structure of the Skull
    N.L. Svintsytska V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 Ministry of Public Health of Ukraine Public Institution «Central Methodological Office for Higher Medical Education of MPH of Ukraine» Higher State Educational Establishment of Ukraine «Ukranian Medical Stomatological Academy» N.L. Svintsytska, V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 2 LBC 28.706 UDC 611.714/716 S 24 «Recommended by the Ministry of Health of Ukraine as textbook for English- speaking students of higher educational institutions of the MPH of Ukraine» (minutes of the meeting of the Commission for the organization of training and methodical literature for the persons enrolled in higher medical (pharmaceutical) educational establishments of postgraduate education MPH of Ukraine, from 02.06.2016 №2). Letter of the MPH of Ukraine of 11.07.2016 № 08.01-30/17321 Composed by: N.L. Svintsytska, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor V.H. Hryn, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor This textbook is intended for undergraduate, postgraduate students and continuing education of health care professionals in a variety of clinical disciplines (medicine, pediatrics, dentistry) as it includes the basic concepts of human anatomy of the skull in adults and newborns. Rewiewed by: O.M. Slobodian, Head of the Department of Anatomy, Topographic Anatomy and Operative Surgery of Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Doctor of Medical Sciences, Professor M.V.
    [Show full text]
  • Partial Closure of Right Superior Orbital Fissure with Narrow Optic Foramen
    eISSN 1308-4038 International Journal of Anatomical Variations (2010) 3: 188–190 Case Report Partial closure of right superior orbital fissure with narrow optic foramen Published online November 26th, 2010 © http://www.ijav.org Shankreppa Doddappa DESAI ABSTRACT Sunkeswari SREEPADMA Superior orbital fissure is situated between the greater and lesser wings of sphenoid, with the optic strut at its superomedial margin. It lies between the roof and lateral wall of the orbit. The superior orbital fissure is divided by the common tendinous origin of the recti muscles. Compression of the neurovascular structures due to variations in the superior orbital fissure may result in signs and symptoms due to involvement of cranial nerves III, IV, V1, and VI. We report here a variation of the superior orbital fissure. Superior orbital fissure was partly closed by a thin plate of bone on the right side, and on the same side there was a narrow optic foramen. It is essential to know such variations to understand the underlying cause for the clinical conditions and operate in those areas. © IJAV. 2010; 3: 188–190. Department of Anatomy, Blde University, Shri B. M. Patil Medical College, Bijapur, Karnataka State, INDIA. Dr. S. D. Desai Professor & Head Department of Anatomy Blde University Shri B. M. Patil Medical College Bijapur-586103, Karnataka, INDIA. +91 8352 262770 ext.:2211 [email protected] Received April 7th, 2010; accepted October 31st, 2010 Key words [superior orbital fissure] [neurological deficits] [superior orbital fissure syndrome] [optic canal] [optic foramen] Introduction in shape and measured 0.9 cm vertically and 1.4 cm Superior orbital fissure is an oblique cleft and connects transversely (Figure 4).
    [Show full text]
  • Spontaneous Encephaloceles of the Temporal Lobe
    Neurosurg Focus 25 (6):E11, 2008 Spontaneous encephaloceles of the temporal lobe JOSHUA J. WIND , M.D., ANTHONY J. CAPUTY , M.D., AND FABIO ROBE R TI , M.D. Department of Neurological Surgery, George Washington University, Washington, DC Encephaloceles are pathological herniations of brain parenchyma through congenital or acquired osseus-dural defects of the skull base or cranial vault. Although encephaloceles are known as rare conditions, several surgical re- ports and clinical series focusing on spontaneous encephaloceles of the temporal lobe may be found in the otological, maxillofacial, radiological, and neurosurgical literature. A variety of symptoms such as occult or symptomatic CSF fistulas, recurrent meningitis, middle ear effusions or infections, conductive hearing loss, and medically intractable epilepsy have been described in patients harboring spontaneous encephaloceles of middle cranial fossa origin. Both open procedures and endoscopic techniques have been advocated for the treatment of such conditions. The authors discuss the pathogenesis, diagnostic assessment, and therapeutic management of spontaneous temporal lobe encepha- loceles. Although diagnosis and treatment may differ on a case-by-case basis, review of the available literature sug- gests that spontaneous encephaloceles of middle cranial fossa origin are a more common pathology than previously believed. In particular, spontaneous cases of posteroinferior encephaloceles involving the tegmen tympani and the middle ear have been very well described in the medical literature.
    [Show full text]
  • CT of Perineural Tumor Extension: Pterygopalatine Fossa
    731 CT of Perineural Tumor Extension: Pterygopalatine Fossa Hugh D. Curtin1.2 Tumors of the oral cavity and paranasal sinuses can spread along nerves to areas Richard Williams 1 apparently removed from the primary tumor. In tumors of the palate, sinuses, and face, Jonas Johnson3 this "perineural" spread usually involves the maxillary division of the trigeminal nerve. The pterygopalatine fossa is a pathway of the maxillary nerve and becomes a key landmark in the detection of neural metastasis by computed tomogaphy (CT). Oblitera­ tion of the fat in the fossa suggests pathology. Case material illustrating neural extension is presented and the CT findings are described. Perineural extension is possibly the most insidious form of tumor spread of head and neck malignancy. After invading a nerve, tumor follows the sheath to reach the deeper connections of the nerve, escaping the area of a planned resection. Thus, detection of this form of extension is important in treatment planning and estimation of prognosis. The pterygopalatine fossa (PPF) is a key crossroad in extension along cranial nerve V. The second branch of the trigeminal nerve passes from the gasserian ganglion through the foramen rotundum into the PPF. Here the nerve branches send communications to the palate, sinus, nasal cavity, and face. Tumor can follow any of these routes proximally into the PPF and eventually to the gasserian ganglion in the middle cranial fossa. The PPF contains enough fat to be an ideal subject for computed tomographic (CT) evaluation. Obliteration of this fat is an important indicator of pathology, including perineural tumor spread. Other signs of perineural extension include enlargement of foramina, increased enhancement in the region of Meckel cave (gasserian ganglion), and atrophy of the muscles innervated by the trigeminal nerve.
    [Show full text]
  • MBB: Head & Neck Anatomy
    MBB: Head & Neck Anatomy Skull Osteology • This is a comprehensive guide of all the skull features you must know by the practical exam. • Many of these structures will be presented multiple times during upcoming labs. • This PowerPoint Handout is the resource you will use during lab when you have access to skulls. Mind, Brain & Behavior 2021 Osteology of the Skull Slide Title Slide Number Slide Title Slide Number Ethmoid Slide 3 Paranasal Sinuses Slide 19 Vomer, Nasal Bone, and Inferior Turbinate (Concha) Slide4 Paranasal Sinus Imaging Slide 20 Lacrimal and Palatine Bones Slide 5 Paranasal Sinus Imaging (Sagittal Section) Slide 21 Zygomatic Bone Slide 6 Skull Sutures Slide 22 Frontal Bone Slide 7 Foramen RevieW Slide 23 Mandible Slide 8 Skull Subdivisions Slide 24 Maxilla Slide 9 Sphenoid Bone Slide 10 Skull Subdivisions: Viscerocranium Slide 25 Temporal Bone Slide 11 Skull Subdivisions: Neurocranium Slide 26 Temporal Bone (Continued) Slide 12 Cranial Base: Cranial Fossae Slide 27 Temporal Bone (Middle Ear Cavity and Facial Canal) Slide 13 Skull Development: Intramembranous vs Endochondral Slide 28 Occipital Bone Slide 14 Ossification Structures/Spaces Formed by More Than One Bone Slide 15 Intramembranous Ossification: Fontanelles Slide 29 Structures/Apertures Formed by More Than One Bone Slide 16 Intramembranous Ossification: Craniosynostosis Slide 30 Nasal Septum Slide 17 Endochondral Ossification Slide 31 Infratemporal Fossa & Pterygopalatine Fossa Slide 18 Achondroplasia and Skull Growth Slide 32 Ethmoid • Cribriform plate/foramina
    [Show full text]
  • MORPHOMETRIC STUDY of PTERION in DRY ADULT HUMAN SKULLS Pratima Kulkarni 1, Shivaji Sukre 2, Mrunal Muley *3
    International Journal of Anatomy and Research, Int J Anat Res 2017, Vol 5(3.3):4365-68. ISSN 2321-4287 Original Research Article DOI: https://dx.doi.org/10.16965/ijar.2017.337 MORPHOMETRIC STUDY OF PTERION IN DRY ADULT HUMAN SKULLS Pratima Kulkarni 1, Shivaji Sukre 2, Mrunal Muley *3. 1 Associate Professor, Department of Anatomy, G.M.C. Aurangabad, Maharashtra, India. 2 Professor and Head of department, Department of Anatomy, G.M.C. Aurangabad, Maharashtra, India. *3 Assistant Professor, Department of Anatomy, G.M.C. Aurangabad, Maharashtra, India. ABSTRACT Introduction: The pterion corresponds to the site of anterolateral fontanelle of the neonatal skull which closes at third month after birth. In the pterional fractures the anterior and middle meningeal arterial ramus ruptures commonly which results in extradural hemorrhage. Pterional approach is most suitable and minimally invasive approach in neurosurgery. Materials and Methods: The present study was carried out on the pterion of 36 dry adult skulls of known sex from department of anatomy GMC Aurangabad Maharashtra. Results: The mean and standard deviation of the distance between the centre of pterion to various anatomical landmarks. The distance between Pterion- frontozygomatic (P-FZ) suture 29.81±4.42mm on right side, 29.81±4.07mm on left side; Pterion-Zygomatic arch (P-Z) 37.16±3.77mm on right side, 37.56±3.71mm on left side, Pterion-asterion (P-A) 89.73±6.16mm on right side, 89.46±6.35mm on left side; Pterion-external acoustic meatus (P- EAM) 53.40±7.28mm on right side, 53.57±6.73mm on left side, Pterion- Mastoid process (P-M) 80.35±3.44mm on right side, 80.96±3.79mm on left side and Pterion- Pterion (P-P) 194.54±16.39mm were measured.
    [Show full text]
  • A Study on Sutural Morphology and Anatomical Position of Pterion
    A STUDY ON SUTURAL MORPHOLOGY AND ANATOMICAL POSITION OF PTERION Varsha Shenoy, P. Saraswathi, T. Siva, D. Jagadeesh ijcrr Department of Anatomy, Saveetha Medical College and Hospital, Saveetha Vol 04 issue 09 University, Saveetha Nagar, Thandalam, Chennai, Tamil Nadu Category: Research Received on:21/03/12 Revised on:29/03/12 E-mail of Corresponding Author: [email protected] Accepted on:06/04/12 ABSTRACT Objective: Pterion is an interesting bony landmark on the lateral aspect of the skull. It is ‗H‘ shaped sutural confluence formed by the articulation of four bones: frontal, parietal, greater wing of sphenoid and squamous part of temporal bone. Pterional approach is most widely used in neurosurgery for a variety of lesions in the anterior and middle cranial fossae. Since previous studies have reported the racial difference in the pterional morphology, in the present study it was aimed to study the sutural morphology of pteria and also to locate it with respect to the frontozygomatic suture. Methods: Seventy five (50 male and 25 female) skulls were studied on both the sides to evaluate the sutural pattern of pteria. The distance between center of the pterion to frontozygomatic suture was measured on both the sides. Results and Conclusion: According to the present study Sphenoparietal pterion was the commonest (77.33%) finding and was followed in frequency by Epipteric type (21.33%) and Stellate type (1.33%). Frontotemporal pterion was not observed. Average distance between the center of pterion and frontozygomatic suture was found to be 2.95 cm. ____________________________________________________________________________________ Keywords: Pterion, Frontozygomatic suture, neuro-vascular disorders located in the anterior Burr-hole surgery, sutural bone, fontanelle, and middle cranial fossae.
    [Show full text]
  • Anthropometric Evaluation of Pterion in Dry Human Skulls Found in Southern India
    Jemds.com Original Research Article Anthropometric Evaluation of Pterion in Dry Human Skulls Found in Southern India Pretty Rathnakar1, Remya Vinod2, Swathi3, Anuja Sinha4 1Associate Professor, Department of Anatomy, K. S. Hegde Medical Academy, Mangalore, Karnataka, India. 2Lecturer, Department of Anatomy, K. S. Hegde Medical Academy, Mangalore, Karnataka, India. 3Associate Professor, Department of Anatomy, K. S. Hegde Medical Academy, Mangalore, Karnataka, India. 4Assistant Professor, Department of Anatomy, K. S. Hegde Medical Academy, Mangalore, Karnataka, India. ABSTRACT BACKGROUND Pterion is a H- shaped sutural convergence seen in the Norma Lateralis of skull. After Corresponding Author: 2-3 months of birth, the anterolateral fontanelle in the neonatal skulls close to form Remya Vinod, Department of Anatomy, the pterion. It is the meeting point of four bones sphenoid, parietal, temporal and K. S. Hegde Medical Academy, frontal. Four types have been noted- spheno-parietal, fronto-temporal, epipteric and Deralakatte, Mangalore-575018, stellate. Pterional approach is commonly undertaken in surgical management of Karnataka, India. tumours involving inferior aspects of frontal lobe, like olfactory meningiomas, orbital, E-mail: [email protected] retro-orbital, sellar, chiasmatic, subfrontal, prepontine areas, anterior circulation and basilar artery aneurysm. The knowledge regarding the various shapes and distances DOI: 10.14260/jemds/2019/541 from different points to pterion (distance of centre of pterion was calculated from mid-point of superior margin of zygomatic arch (PZA), Frontozygomatic suture (PFZ), Financial or Other Competing Interests: None. tip of the mastoid process (PMP), and anterosuperior margin of external acoustic meatus (PEAM)) is useful for treating number of pathologies in brain. So, this is also How to Cite This Article: useful for neurosurgeons, anatomists, anthropologists and forensic medicine Rathnakar P, Vinod R, Swathi, et al.
    [Show full text]
  • Inter-Parietal Bones in Neurocranium of Human Adult Dry Skulls K
    International Journal of Current Medical And Applied Sciences, 2015, December, 9(1),44-47. ORIGINAL RESEARCH ARTICLE INCA- Inter-Parietal Bones in Neurocranium of Human Adult Dry Skulls K. Arumugam 1 & A. Arunkumar 2 1Assistant Professor, Department of Anatomy, Tirunelveli Medical College, Tirunelveli.Tamil Nadu, India. 2Tutor, Andamon Nicobar Island of Institute of Medical Sciences, Andaman. India. ---------------------------------------------------------------------------------------------------------------------------------------------------- Abstract: Skull means the skeleton of the head including mandible and calvaria means skull after the bones of the face have been removed. In this the word skull is frequently used instead of cranium as a matter of convenience and common usage Objectives: To determine the incidence and type of INCA variants in human adult dry skull. Materials and Methods In this study, 100 human dried skulls were analyzed. All the skulls were taken from the Institute of Anatomy, Madras Medical College, Chennai. Results: Gross incidence of INCA was found to be 2%. The INCA occurred in single. Conclusion: This study gives idea of INCA regarding gross incidence, number and type. This knowledge is useful for neurosurgeons, anthropologists and radiologists. Key words: Neurocranium, INCA bone, Sutural bones. Introduction: According to the catalogues of craniological collections, fontanelle and paired posterior-lateral fontanelle. skull means the skeleton of the head including These fontanelles allows the expansion of the foetal mandible and calvaria means skull after the bones of head to accommodate the rapid enlargement of brain the face have been removed. In this the word skull is which take place during postnatal life. During frequently used instead of cranium as a matter of parturition the fontanelles also help in moulding of the convenience and common usage [2].
    [Show full text]