ABSTRACT
Introduction: Anterior sylvian point (ASyP) had a constant relationship with a point in the skull just posterior to the “H”-shapedpterion over the squamous suture called the anterior squamous point (ASqP).Objectives: The objectives of this study were as follows: (1) To confirm and establish the cisternal nature of ASyP and itsrelationship to other important neural and sulcal structures along the sylvian fissure. (2) To confirm the relationship of theAntSyP (ASyP) with the external cranial landmark ASqP for surface mapping of frontal horn for emergency ventricular tapping.Materials and Methods: Forty adult human brains (20 – right side and 20 – left side), both male and female, were observedduring surgery in Government Theni Medical College. Reliability of frontal horn tapping using the apex of Paine’s trianglefrom ASyP as the entry point was analyzed using the following steps. Exposure of pterion by the standard FTP trauma flapincision. Standard FTP craniotomy opening of the skull and dura mater and observing for ASyP relation to ASqP. A catheterwas introduced through the apex of the Paine’s triangle identified using the surgical tapes to form a 2.5 cm isosceles trianglefrom the ASyP. A study of the relationship of ASyP to the external cranial surface, middle cerebral artery (MCA) bifurcation,and frontal horn of ventricles was done.Conclusion: It could be safely concluded that ASqP is a reliable external cranial landmark for ASyP. ASyP can be the referencepoint for Paine’s triangle and hence Paine’s point. Hence, Paine’s point could be used to tap the frontal horn in emergentsituations. Furthermore, MCA bifurcation can be reached by ASyP cisternal dissection.