Anatomoradiological identification of intrasutural bones for importance of cranial fracture

Abstract

AIm: Intrasutural bones are often found within sutures and fontanelles of the skull. It is important that the anatomy of these bones in the field of non-accidental injury with respect to medicolegal complications. Skull fracture lines are critical in their differential diagnosis, and the features of bone formations, their appearance and position give us a more definitive diagnosis. mATERIAL and mETHods: Intrasutural bone location, its number and symmetry were investigated in totally 300 adult skulls.REsuLTs: 27 intrasutural bones were identified as interparietal (2%), preinterparietal (3%) and sutural bones (4%) were in the lambdoid sutures. It was detected that the interparietal and preparietal bones were single, and the sutural ones were in a multiple number. The sutural bones were superposed in significant structures such as sagittal sinus and sinus sigmoideus. CoNCLusIoN:The ones that should be paid attention to in the differential diagnosis of the skull fracture lines are preinterparietal and interparietal bones in larger sizes. These findings prompted us to report these cases as their presence can lead to confusion in diagnosis in cases of skull fractures. BuLGuLAR: 27 tane sütüral kemik tanımlandı: interparietal (%2), preinterparietal (%3) ve sütüral kemik (%4) tanımıyla lambdoid sütür kemiği. Interparietal ve preparietal kemikler tek, sütüral olanları ise çok sayıda idi. Sütüral kemikler aynı zamanda sagittal sinüs ve sigmoid sinüs gibi önemli yapıların üzerine yerleşmiş idi. soNuÇ: Preparietal ve interparietal kemiklerin daha büyük boyutlarda olması kırık hattı ayırıcı tanısında dikkat edilmelidir. Bu olgularda elde ettiğimiz kemiklerin, tanıda kafa kırıkları ile karışabileceği yönündedir.

Incidence, number and topography of Wormian bones in Greek adult dry skulls

“…A similar high incidence (80.32%) was reported in Chinese [5], whereas in West Anatolian and Eastern Indian skulls, the reported incidences were 59.3% and 45%, respectively [8,14]. The lowest incidence (9%) was reported by Govsa et al [15] in Turkish skulls. Cirpan et al [8] along with current study highlighted a stronger number of multiple WBs found in skulls (44.6% and 39.3%, respectively).…”

“…Wormian bones are of diagnostic value, since their presence may be occasionally misinterpreted of view in forensic investigation of non-accidental skull injuries in order to rule out physical abuse and brittle bones [15]. In some cases, the traumatic lesion of a gunshot entry wound of the skull, may have similarities with the orifice of a WB, thus emphasis must be given on differential diagnosis during routine anthropological examination.…”

An anatomical study of wormian bones from the eastern part of India: is genetic influence a primary determinant of their morphogenesis?

“…It has been conclusively established that the presence of SNWBs can act as a marker for early diagnosis of bony dysplasias, particularly osteogenesis imperfecta (Semler et al 2010). Details of the topographical distribution of wormian bones could be useful to radiologists and forensic experts in successfully differentiating a skull fracture/injury and a normal suture, and thereby exclude possibilities of physical abuse and brittle bones (Govsa et al 2014).…”

“…Some recent studies have even reported that the presence of wormian bones may serve as a marker for identification of anomalies involving the central nervous system (Jeanty et al 2000). Anatomical details of wormian bones are also valuable from medico-legal point of view in the forensic investigation of non-accidental skull injuries in children as well as adults (Govsa et al 2014).…”

Facial trauma misdiagnosed on the computed tomography scan: Case report

“…Govsa ve ark. [6], intrasutural kemiklerin yanlışlıkla kırık olarak yorumlanabileceğinden bahsetmektedir. Suturalar anatomik varyasyongösterebilmektedir [7].…”