The pathophysiological changes underlying impairment of cognition in Parkinson's disease (PD) are complex and not fully understood till date. Hence, understanding the structural changes responsible for cognitive decline in PD is essential for early diagnosis and to offer effective treatment. In this review, we discuss the neuroanatomical changes in major brain structures responsible for cognition in PD. We have included the key findings of various studies to provide up-to-date information for better understanding of pathophysiology of PD, which will help researchers and clinicians in planning and developing new treatment methods for the benefit of PD patients.

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Background:The frontal bone is ossified in fibrous mesenchyme from two primary centers, one near each frontal tuber. At birth the bone consists of two halves. The median suture usually disappear by about 8 years, but may persist as the metopic suture. Metopic suture present at birth between the right and left halves of the frontal bone and closes at 2-5 years of the age, but may present during adult life. The suture closure began endocranially and it spread to pericranium. Materials and Methods:Total 500 skulls were used for this study from different medical institutions of south India.Results: Out of 500 skulls, 11(2.2%) skulls showed complete metopic suture and 108(21.6%) skulls showed in complete metopic suture. Conclusion:The Knowledge of metopic suture is very important in radiological and orthopedic surgeons during their practice in head injuries and it also important in practice of anthropologists and neurosurgeons.

During routine dissection of an adult male cadaver, we found the following bilateral multiple variations in the carotid arteries. The left common carotid artery [Table/ Fig-1] bifurcated at the level of hyoid bone. The right 3] bifurcated in between the upper border of thyroid cartilage and hyoid bone. We found both the external and internal carotid arteries were tortuous in their course. The internal carotid was showing siphon at the level of tip of styloid process on both sides. The kinking was graded as grade 3 with angulation less than 30 0 . The left was relatively more tortuous than the right. The length of left external carotid was 8cm and right was 7cm. The measurements were taken from the point of bifurcation of common carotid artery upto the point where the external carotid artery gave the terminal branches namely maxillary artery and superficial temporal arteries. The length of internal carotid arteries were 7.3cm on right side and 7cm on left side. They were measured from point of bifurcation of common carotid artery up to the entry of internal carotid into carotid canal on the base of skull.Branches from the external carotid also showed variations. The superior thyroid artery arose from the common carotid much below the level of bifurcation on left side and at the level of bifurcation on right side. Supernumerary branches were arising from both the sides, namely, Arteries to Sternocleidomastoid muscle, tonsillar branches, Total 9 branches from right side of which 2 were branches to sternocleidomastoid muscle and 11 branches from left side of which 2 were branches to sternocleidomastoid muscle and one branch to tonsil. The branches to Sternocleidomastoid were crossing the internal carotid artery superficially and supplying the muscle. The tonsillar branch on left side passed along with internal carotid artery and then turned medially to enter the oropharynx to supply the palatine tonsil. DisCussionAnatomical variations occur throughout the course of carotid arteries. Variations may occur in origin, branching pattern and level of bifurcation.

During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in the arm gave anterior circumflex humeral artery at the surgical neck of humerus, which terminated in the cubital fossa by dividing into radial and ulnar arteries. The superficial brachial artery gave two profunda brachii arteries, both of which passed through spiral groove, along with radial nerve and three muscular branches, to brachialis muscle. This variation is very rare. As per our knowledge, we did not find any literature which explained variations which were similar to this. The normal and abnormal anatomy of the axillary region has practical importance among vascular radiologists and surgeons and it should be known for making an accurate diagnostic interpretation.

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