Metopism: An anatomical variant that the physician should take into account

Abstract

Introduction: During childhood these sutures close, forming the characteristic sutures of the skull, one of these is the frontal suture, which joins the two frontal bones perfectly, simulating a single frontal bone. However, this suture can persist into adulthood, giving an anatomical variant known as metopism. Case Report: A 19-year-old Mexican male presented with high-energy trauma related to a traffic accident while riding a motorcycle without wearing a safety helmet. A simple skull computed tomography (CT) was considered due to moderate risk factors for traumatic brain injury (TBI), based on the Master’s classification, progressive headache, presence of hematoma, facial injuries. When performing the simple skull tomography, persistence of the metopic suture was observed. Conclusion: Metopism has generally been reported as a postmortem finding in population studies aimed at its search. This report has special attention because it was identified as a differential diagnosis of a skull fracture following a traumatic brain injury. The important finding that differentiates metopic suture from a fracture is the presence of serrated and sclerotic edges. A persistent metopic suture can be easily diagnosed by an anteriorposterior radiograph.