Morphometric evaluation of the anterior cranial fossa during the prenatal stage in humans and its clinical implications

AbstractThe research presents findings from a study on the development of the skull and brain in human fetuses, specifically focusing on the anterior cranial fossa. This area provides protection for the frontal lobes, which are crucial for human personality development later in life. The study describes the anatomical structure of the anterior cranial fossa during the prenatal period and examines disorders that may lead to congenital defects. The aim was to assess the anterior cranial fossa during prenatal development using innovative computer image processing techniques not previously applied in this anatomical area. A metrological analysis of the human anterior cranial fossa was conducted at various developmental stages, and the study explored the relationship between selected dimensions and developmental age. It compared the development of the anterior cranial fossa to that of the other two cranial fossae, investigating symmetry during development and sexual dimorphism of the anterior fossa and skull base before birth. The study also considered clinical aspects, including a mechanical model of developing skull based on obtained results, enabling the approximation of the pathomechanism of congenital skull and brain defects and potential treatment options. The study included a collection of 77 human fetuses aged between 10 and 27 weeks of gestation. Computer image processing techniques were employed, representing a novelty in neuroanatomical research. The study also discussed the advantages of computerized image acquisition and measurement methods over traditional anatomical preparation methods, particularly due to the possibility of non-contact measurements, crucial for delicate neural tissue of fetal brains. Detailed results obtained were presented along with their statistical analysis. The study found that during the development of the human cranial base, the angle of the anterior cranial fossa decreased, compensated by an increase in the angle of the middle cranial fossa. It was also noted that the development of the cranial base within the studied age range occurred symmetrically relative to the midline plane of the body. Sexual dimorphism of the anterior fossa was evident in the prenatal period, with male fetuses exhibiting a larger angle compared to female fetuses, while female fetuses exhibited greater height of the crista galli of the ethmoid bone. The study also discussed the findings regarding the skull’s structure in relation to function, describing it as resembling an elevated drop-shaped tank associated with the containment of cerebrospinal fluid and highly hydrated brain tissue. Additionally, the study observed the formation of the so-called Felizter’s supporting arches, a ribbed system formed at the lower part of the skull tank, stiffening the shell structure. In our discussion, we compared our results with existing research in this field. We looked at earlier studies on fetal skull anatomy and reviewed findings from prenatal and neonatal imaging studies. We emphasized the clinical significance of skull geometry, including specific lines used to diagnose skull base depression, such as Chamberlain, McGregor’s basal, McRae’s, Wackenheim, and Fischgold. We also presented the results of our own research using computer image processing methods. Additionally, we considered the potential for prenatal treatment of certain congenital defects based on the latest research and attempted corrections before birth.