anatomy

Anatomy

1308-8459

Society of Anatomy and Clinical Anatomy

Health Care Administration

Sağlık Kurumları Yönetimi

Localization of the bregma and its clinical relevance

https://orcid.org/0000-0003-2015-9484

Solmaz

Bilgehan

Department of Neurosurgery , İstanbul Education and Research Hospital , İstanbul.

12 31 2018

12 3 135 139 11 16 2018 04 26 2019

2007

Anatomy

Objectives: External landmarks onthe skull are important guides in various neurosurgical procedures. Thelocalization of the bregma is vitally important in bedside ventriculostomy andcraniotomies. The aim of the current study was to verify the localization ofthe bregma.Methods: This was performed on dryskulls (n=72) and sagittal computerized tomography (CT) images of patients(n=100). The age and the sex of dry skulls were unknown. Of the 100 patients,48 were males and 52 were females and the mean age for males was 51.14 and forfemales was 55.34. The distance between nasion to inion and nasion to bregmawere measured from both dry skulls and on multiplanar reformation (MPR)sagittal images. The ratio of the two measurements was calculated.Results: The nasion to bregmadistances on 72 dry skulls ranged between 120–140 mm: the average distance was124.3±6.9 mm. The nasion to inion distance ranged between 295–345 mm; theaverage was 320.8±14.4 mm. The ratio of nasion to bregma distance to nasion to iniondistance was calculated as 0.384. The nasion to bregma distance obtained from100 CT images scans ranged from 107 to 139 mm (average 126.6±7.3) mm. Thenasion to inion distances ranged between 301 and 356 (average 330.2±15.2) mm.The ratio of nasion to bregma distance to nasion to inion distance wascalculated as 0.383. Measurements for females were lower than males, but therewas no statistical significance between genders. The multiplication of thenasion to inion distance by 0.38 gave the location of bregma for both genders.Conclusion:An accurate and reliable ratio (0.38 times the distance from nasion to inion)was obtained to define the bregma. The coronal suture lay on each side ofbregma, so knowing the exact localization of bregma and of the coronal suturecan be vitally important in various surgical procedures to the cranium.

coronal suture craniotomy ventriculostomy external landmark

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