RESUMO
INTRODUCTION: The pterion and asterion serve as crucial landmarks on the skull, representing the antero-lateral and postero-lateral fontanelles in neonates, respectively. In clinical practice, these points play a pivotal role in guiding the understanding of deeper structures and their relationships to the head's surface. The thin calvarium at these junctures is susceptible to fractures, and the underlying vessels are prone to tear, often leading to extradural hematoma formation, necessitating burr hole surgery for evacuation. MATERIAL AND METHODS: The study involved 40 human dry skulls in Indians (n= 27 male (10.8%), n= 13 female (5.2%)) of unknown age, evaluating morphometric characteristics of 80 pterions and asterions. Measurements were conducted using a digital caliper (SKADIOO±0.2mm/0.01") in millimeters on both sides of each skull. The investigation also included an examination of sutural patterns in Pterion and asterion. RESULTS: Three types of sutural patterns were identified in the pterion, the most common being the sphenoparietal variety (75% on the right, 70% on the left), followed by the epipteric variety, which was the second most common (11.3% on the right, 12.5% on the left), and then the frontotemporal type (1.3% on the right, 2.5% on the left). Two sutural patterns were observed in the asterion: type 1 (presence of sutural bone) in 17.9% of skulls and type 2 (absence of sutural bone) in 82.1%. CONCLUSION: The differences in pterion and asterion positions across various populations explored in previous studies motivated us to conduct this research in the Indian population. Our findings revealed that among Indians, the predominant pterion type is predominantly sphenoparietal, whereas type 2 is the most prevalent in asterion. Understanding the clinical significance of the pterion and asterion is crucial for healthcare professionals to ensure precise and safe surgical procedures, particularly for the effective treatment of head trauma patients.
RESUMO
BACKGROUND: The course and variations of thyroid arteries must be understood by surgeons to prevent bleeding during operative procedures of the thyroid gland. There is limited scientific literature regarding the radiological anatomy of thyroid arteries in this geographical area, the Garhwal region of Sub-Himalayan belt, which is considered to be the endemic belt of goiter. Computed tomography angiography provides a three-dimensional orientation of the vascular and surgical anatomy of the entire cervical region. AIM: To estimate the proportion of variation in origin of thyroid arteries using Computed Tomography Angiography. METHODS: Using Computed Tomography Angiography, the presence and origin of the superior thyroid artery, inferior thyroid artery, and thyroid ima artery were observed and assessed. RESULTS: Out of total 210 subjects, superior thyroid artery was seen to be emerging from external carotid artery in 77.1% cases. The artery was found to be originating at the level of bifurcation of common carotid artery in 14.3% cases, whereas in 8.6% cases, it emerged as a direct branch of the common carotid artery. Similarly, the inferior thyroid artery was observed to be emerging from thyrocervical trunk, subclavian artery and vertebral artery in 95.7% cases, 3.3% and 1% cases, respectively. Thyroid ima artery was also reported in a subject, arising from the brachiocephalic trunk. CONCLUSION: To avoid vascular injuries, excessive and uncontrollable bleeding, intra-operative difficulties, and post-operative issues, it is imperative for surgeons to be aware of the course and variations of thyroid arteries.
