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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1116-1121
DOI: 10.4103/ajns.AJNS_201_19
Original Article

X-ray and computed tomography scan-based morphometric analysis of skull baselines in Indian population

Nandan Marathe
0   Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra
,
Aditya Dahapute
0   Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra
,
Jigar Desai
0   Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra
,
Kiran Dhole
1   Department of Orthopaedics, BYL Nair Hospital, Mumbai, Maharashtra
,
Shubhanshu Bhaladhare
1   Department of Orthopaedics, BYL Nair Hospital, Mumbai, Maharashtra
,
Swapneel Shah
0   Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra
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Introduction: The study aims at providing an overview of morphometric measurements of the skull baselines in normal Indian population and compares these dimensions with those of other races and ethnicities. This study will help in defining “normal” baseline values for Indian population. It will also compare dimensions as measured on X-ray and computed tomography (CT) scan to assess the reliability of X-ray as a diagnostic modality for the assessment of the skull baselines in Indian population. Materials and Methods: Retrospective study with a sample size of 116 patients and duration of 30 months. Results: The mean value for distance between dens tip and Chamberlain line on CT was 0.498 mm and on X-ray was 0.528 mm and for the distance between dens tip and McGregor line on CT was 0.213 mm and on X-ray was 0.228 mm. The mean distance between the dens tip and McRae line was 4.67 1.69 mm on CT scan and 4.7 1.76 mm on X-ray. Conclusion: There was not a single patient in whom the dens tip crossed the McRae line. Any protrusion of the dens tip beyond the foramen magnum is abnormal. Hence, the McRae line is easiest to understand and remember. Furthermore, the Chamberlain and McGregor lines rely on identifying the hard palate, which may not be included in routine X-ray, CT, and magnetic resonance imaging studies depend on the field of view. Hence, we recommend the use of McRae line for screening purposes while evaluating pathologies of the craniovertebral junction. X-ray is a reliable diagnostic technique for assessing morphometry of the skull baselines in an emergency or rural setting if facility for CT scan is not available.

Key-words:

Basilar invagination - Chamberlain - McGregor - McRae

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Chamberlain WE. Basilar impression (Platybasia): A bizarre developmental anomaly of the occipital bone and upper cervical spine with striking and misleading neurologic manifestations. Yale J Biol Med 1939;11:487-96.
  • 2 McGreger M. The significance of certain measurements of the skull in the diagnosis of basilar impression. Br J Radiol 1948;21:171-81.
  • 3 McRae DL, Barnum AS. Occipitalization of the atlas. Am J Roentgenol Radium Ther Nucl Med 1953;70:23-46.
  • 4 Tassanawipas A, Mokkhavesa S, Chatchavong S, Worawittayawong P. Magnetic resonance imaging study of the cranio- cervical junction. J Ortho Surg 2005;13:228-231.
  • 5 Patwardhan AR, Nemade PS, Bhosale SK, Srivastava SK. Computed tomography-based morphometric analysis of cervical pedicles in Indian population: A pilot study to assess feasibility of transpedicular screw fixation. J Postgrad Med 2012;58:119-22.
  • 6 Gopalrao SR, Solanke P, Ugale M, Balsurkar S. Computed tomographic scan study of morphometry of foramen magnum. Int J Curr Res Rev 2013;5:41-8.
  • 7 Chow SC, Chow J, Wang H, Lokhnygina Y. Sample size calculations. In: Clinical Research. New York: Taylor & Francis; 2003. p. 50-2.
  • 8 Shrout PE, Fleiss JL. Intraclass correlations: Uses in assessing rater reliability. Psychol Bull 1979;86:420-8.
  • 9 Chethan P, Prakash KG, Murlimanju BV, Prashanth KU, Prabhu LV, Saralaya VV, et al. Morphological analysis and morphometry of the foramen magnum: An anatomical investigation. Turk Neurosurg 2012;22:416-9.
  • 10 Kumar A, Dave M, Anwar S. Morphometric evaluation of foramen magnum in dry human skulls. Int J Anat Res 2015;3:1015-23.
  • 11 Batista UC, Joaquim AF, Fernandes YB, Mathias RN, Ghizoni E, Tedeschi H. Computed tomography evaluation of the normal craniocervical junction craniometry in 100 asymptomatic patients. Neurosurg Focus 2015;38:E5.
  • 12 Kwong Y, Rao N, Latief K. Craniometric measurements in the assessment of craniovertebral settling: Are they still relevant in the age of cross-sectional imaging? AJR Am J Roentgenol 2011;196:W421-5.
  • 13 Cronin CG, Lohan DG, Mhuircheartigh JN, Meehan CP, Murphy J, Roche C. CT evaluation of chamberlain's, McGregor's, and McRae's skull-base lines. Clin Radiol 2009;64:64-9.
  • 14 Cronin CG, Lohan DG, Mhuircheartigh JN, Meehan CP, Murphy JM, Roche C, et al. MRI evaluation and measurement of the normal odontoid peg position. Clin Radiol 2007;62:897-903.