The pterion is a clinically significant landmark located on the lateral side of the skull. It represents the convergence of four bones: the frontal, parietal, temporal, and sphenoid bones. The pterion is not only important anatomically but also surgically, as it is situated over the anterior branch of the middle meningeal artery, making it a vulnerable area for injuries, such as epidural hematomas, if fractured.

The sutures associated with the pterion are:

• Frontosphenoidal suture – between the frontal and sphenoid bones.
• Sphenoparietal suture – between the sphenoid and parietal bones.
• Sphenosquamous suture – between the sphenoid and temporal bones.
• Squamosal suture – between the temporal and parietal bones.
• Coronal suture – between the frontal and parietal bones.

Additional details about the pterion:

• The location of the pterion varies slightly between individuals but is generally located about 4 cm superior to the midpoint of the zygomatic arch and 3-4 cm posterior to the frontozygomatic suture.
• The underlying middle meningeal artery can be injured in trauma, leading to life-threatening bleeding in the form of an epidural hematoma.
• The region is used as a reference point in neurosurgical approaches, particularly in craniotomies to access the anterior ,middle cranial fossae an the orbit.
• The pterional anatomy is important as the issue typically arises when operating on the temporal and frontal bones, with the most common approach being the pterional or frontotemporal approach.

Understanding the anatomy of the pterion and its associated sutures is crucial in both clinical and surgical contexts, particularly in managing head trauma and neurosurgical interventions.

Figure 1 : Right sided pterional approach. the temporalis muscle has been cutted and displaced inferiorly.