2013, Number 4
<< Back Next >>
Cir Cir 2013; 81 (4)
Morphometric characteristics of the asterion and the posterolateral surface of the skull: it’s relationship with dural venous sinuses and its neurosurgical importance
Galindo-de León S, Hernández-Rodríguez AN, Morales-Ávalos R, Theriot-Girón MC, Elizondo-Omaña RE, Guzmán-López S
Language: Spanish
References: 13
Page: 269-273
PDF size: 328.78 Kb.
ABSTRACT
Background: The knowledge of the location and morphometric
of the lateral venous sinus (transverse and sigmoid), and their
relationship with the asterion and other surface anatomical
landmarks, it is imperative for posterolateral approaches to the
posterior cranial fossa to avoid vascular structures injury and
surgical complications.
Objective: Determine an anatomical area security for a drill that
allows entry into the posterior cranial fossa without damaging
adjacent structures, and study the morphometric characteristics
asterion, the lateral sinus and bony landmarks of the posterolateral
surface of the skull.
Methods: With a 1.3 mm drill drilled both sides of 88 dry skulls
(176 hemicranias). The anatomical landmarks studied were the
asterion, the apex of the mastoid process, spina suprameatal, the
Frankfurt horizontal plane, the posterior root of the zygomatic arch,
the external occipital protuberance and its relationship with the
sinus transversus.
Results: The asterion type I prevails in 74.4% of the pieces. In
82.4% of the skulls asterion level is, sinus transversus in less than
12.5% and above this at 5.1%.
Conclusions: With the data obtained from this and other
research, the initial trephine should be placed below the 15 mm
and 15 mm asterion post this to reduce the risk of injury from
sinus transversus.
REFERENCES
Martínez F, Laxague A, Vida L, Prinzo H, Sgarbi N, Soria VR, et al. Anatomía topográfica del asterion. Neurocirugía 2005;16:441-446.
Bozbuga M, Boran BO, Sahinoglu K. Surface anatomy of the posterolateral cranium regarding the localization of the initial burrhole for a retrosigmoid approach. Neurosurg Rev 2006;29:61-63.
Mwachaka PM, Hassanali J, Odula PO. Anatomic position of the asterion in Kenyans for posterolateral surgical approaches to cranial cavity. Clin Anat 2010;23:30-33.
Tubbs RS, Elton S, Grabb P, Dockery SE, Bartolucci A, Oakes WJ. Analysis of the Posterior Fossa in Children with the Chiari 0 malformation. Neurosurgery 2001;48:1050-1055.
Avci E, Kocaogullar Y, Fossett D, Caputy A. Lateral posterior fossa venous sinus relationships to surface landmarks. Surg Neurol 2003;59:392-397.
Tubbs RS, Loukas M, Shoja MM, Bellew MP, Cohen-Gadol AA. Surface Landmarks for the Junction Between the Transverse and Sigmoid Sinuses: Application of the “Strategic” Burr Hole for Suboccipital Craniotomy. Neurosurgery 2009;65:37-41.
Morales-Avalos R, Aguilar-Alvarado MV, Elizondo-Omaña RE, Guzmán-López S. Estudio Morfológico del pterion y asterion en cráneos adultos mexicanos. Rev Arg de Anat Clín 2011;3:77-83.
Sarnat HB. Disorders of segmentation of the neural tube: Chiari malformations. Handb Clin Neurol 2007;87:89-103.
Ucerler H, Govsa F. Asterion as a surgical landmark for lateral cranial base approaches. J Craniomaxillofac Surg 2006;34:415-420.
Uz A, Ugur HC, Tekdemir I. Is the asterion a reliable landmark for the lateral approach to posterior fossa? J Clin Neurosci 2001;8:146- 147.
Day JD, Kellogg JX, Tschabitscher M, Fukushima T. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery 1996;38:1079-1084.
Day JD, Tschabitscher M. Anatomic Position of the Asterion. Neurosurgery 1998;42:198-199.
Day JD, Manfred T. Anatomic Position of the Asterion: Anatomical report. Neurosurgery 1998;42:198-199.