Location and morphological study of pterion – A landmark for keyhole neurosurgical procedures

Abstract

Background: Pterion is the conjunction of four bones of the skull, which is clinically significant because of the middle meningeal artery that passes beneath it. It forms an important landmark for neurosurgical approaches to the anterior and middle cranial fossa. Methods: Two hundred and forty dried human skulls were studied on both sides for variations in the morphology of pterion. Distance of the significant anatomic landmarks was calculated from the centre of the pterion using slide callipers. Results: Sphenoparietal type (70%) was most commonly found among the specimens followed by stellate (25%) and epipteric (5%) pterion. No intertype variation was noted. Higher percentage of asymmetric combinations (60%) were observed compared to symmetric combinations (40%). Conclusions: Variation in the morphology as well as the location is crucial for drilling burr holes for evacuating extradural haematomas and performing other procedures.

Keywords

• morphometry
• neurosurgery
• pterion