In the first case, as can easily be imagined or even artificially demonstrated, there would be possible only a lower or higher situation or an obliquity affecting mostly the marginal portion of the division. The results would be low or high sagittal sutures, and curved or oblique sutures diverging from the parietal eminence,--effects entirely different from the actually observed oblique sutures that sever the lower portion of the parietal, or its mastoid angle.
Influences interfering with the free development of the anterior or posterior border of the parietal bone could only deflect upwards or downwards the marginal end of an incomplete parietal suture, or, at most, in a case of a short suture, render it oblique or curved in its entirety. No pathological condition, unless it were accompanied by a fracture, could extend even a deflected antero-posterior incomplete division to any of the borders of the bone.
There are, it seems to me, only three possible ways in which an oblique suture, extending between any two borders of the parietal bone, can be produced.
In the first case the oblique suture, or rather a suture-like formation, may be the effect of an early fracture. A fracture produced in adult life is generally recognizable as such; but a fracture dating from earlier stages of life, produced before the growth of the bone has ceased, may, if not entirely obliterated, present more or less the characteristics of a suture. I have seen several skulls where a division in the parietal bone or the temporal squama presented at the same time features of a fracture and suture; in one or two of these cases so much so, that it was and still is impossible for me to decide exactly which of the two conditions I had before me. Gruber describes one such case as an instance of an oblique parietal suture, while Hyrtl and Ranke both consider this case as one with an acquired division. To differentiate a congenital real oblique suture from a division which is the result of a fracture, we must be guided largely by the situation, form, and serration of the division, and the condition of the surrounding bones, especially that of the opposite parietal. A straight course, ending with one extremity in or near the middle of the anterior or posterior border of the parietal, a complex serration, no continuity of the division on the neighboring bones, and particularly a co-existence of an allied or similar division on the opposite parietal,--all favor the conclusion that the division under consideration is a real congenital suture, and not the result of a fracture.
In the second case there are reasons for believing that an oblique suture of the parietal bone can originate in the same way as the horizontal one, namely, through a persistence of the original separation between the two centres from which the bone is developed, and a co-existent difference in the relative position or the relative growth of the two centres. It is in this connection that the above-described division in the parietals of the chimpanzee will prove of value.
The occasional persistence of the separation between the two original segments of the parietal bone is sufficiently demonstrated by the presence of the complete horizontal parietal suture. Differences in the relative position of these segments can be observed in a limited degree in Ranke's illustrations of embryos, before referred to; it can be deduced from such cases as the two of Hyrtl, in which the division of the parietal was directed from the upper portion of the anterior to the lower portion of the posterior border of the bone. The most pronounced change in the position of these centres may be witnessed in cases where the parietal bone shows a perfect vertical instead of a horizontal suture. Such cases have been referred to before, and I presented at the meeting of the Association of American Anatomists, in 1899, several such examples, found by me in skulls of monkeys in Professor Huntington's anatomical collection in the Medical Department of Columbia University. One of these specimens is shown in the accompanying illustration (Fig. 5).
A difference in the relative growth of the two centres of the parietal bone is well shown in the difference of size between the inferior and superior portions of the parietal in cases of the complete horizontal suture in the same. In the majority of such cases on record the superior portion is larger, particularly anteriorly, than the inferior; so much so, that that condition seems to be the typical one. The difference in the size of the two portions of the parietal, and in their relative anterior and posterior height, is most pronounced in one of Gruber's cases, where the "parietal suture" begins only 10 mm. above the pterion, and ends 40 mm. above the asterion. In Dorsey's case the lower portion of the divided parietal is 12 mm. higher than the upper. The same condition as is found in Gruber's case, here mentioned, exists in the almost identical left division of the second case of Putnam, of which I have a photograph in my hands. A somewhat similar excess of the posterior over the anterior part of the lower severed portion of the parietal can also be seen in the illustrations of the cases of Tarin, Lucae, and Turner (Admiralty Islands skull). In Calori's interesting case there is a decided excess of the lower portion of the divided parietal in its posterior portion on the left and in its anterior portion on the right side.
In case the upper segment was not vertically above the lower one, but in a position a little more forward or backward of it; and, furthermore, if the relative growth of the two segments differed, and their separation remained permanent,--the separation of any portion of the parietal bone in almost any form and to almost any extent might result. Such coincidence of anomalous conditions, although necessarily rare, cannot, from what we know on the subject in parietal and other bones, be declared improbable. All cases where oblique suture on one side co-exists with more or less horizontal suture on the other side in the parietal bone, as in the second of Putnam's cases, would of course point directly to a similar origin of the anomaly on both sides of the cranium. That such cases have not been more frequently observed is largely due, I think, to the rarity of bilateral parietal divisions.
A third mode of development of the oblique suture in the parietal bone suggests itself where the severed portion of the bone is small, and that is the possible existence of a supernumerary, third centre of ossification. I am by no means ready to defend this theory, yet there are cases in which it would afford the easiest explanation. I have a Peruvian skull at hand, in which there is a bilateral, quite symmetrical quadrangular separate piece of bone, encroaching on the mastoid process of the parietal. The surface of the left parietal bone in this skull measures across its middle in antero-posterior direction 120 mm., in infero-superior direction 130 mm.; similar measures of the right parietal are respectively 117 and 130 mm. The separate bone on the left measures across its middle in antero-posterior direction 20 mm., in infero-superior direction 12 to 21 mm.; the same portion on the right measures respectively 25 and 11 to 15 mm. Both pieces are joined to the parietal bone by a squamous suture (Fig. 6).
It is apparent that the separate pieces of bone in this case are too small to be easily taken for representatives of one of the regular centres of ossification of the parietal bone; but the same pieces are somewhat too large, and especially too singularly outlined and joined to the parietal, to be without difficulty diagnosed as simple Wormian or fontanel bones. One of Ranke's cases, though the separation of the mastoid angle is oblong instead of quadrangular, as in the Peruvian skull, seems to me to present a similar difficulty in properly diagnosing the nature of the severed portion. This group of cases needs further observation, particularly on the bones of infants and embryos. I have two monkey skulls at hand which actually show a multiplicity of the original segments of the parietal. These specimens will be described in a future publication.
So much as to the formation of the oblique sutures in the parietal. It should not be forgotten that such sutures can be simulated by those which divide true Wormian or fontanel bones from the parietal. The distinction between the real oblique parietal and these extra-parietal sutures must depend largely on the extent of the division and form of the separate piece of bone.
We may now return to the skull of our chimpanzee. In considering the nature of the divisions in the parietal bones of this skull, we can at once and absolutely discard the idea of the divisions being due to fractures, or being boundaries of Wormian or fontanel bones, and thus really extra-parietal in their nature. There is nothing about the sutures, or the divided pieces, or the neighboring bones, that would even suggest such an explanation; and in our records on Wormian and fontanel bones we find no analogies either in man, or apes, or lower animals, to the conditions here observed. The necessary conclusion from this can only be that we have before us two examples of real parietal division.
The division on the left side, had it existed alone, would be readily acceptable as an instance of the "parietal suture." The anterior extremity and more than the anterior third of the course of the division correspond exactly to the same features of a typical, horizontal "parietal suture;" while the elevation of the posterior extremity of the division, though unusual, can readily be explained as due to an excess in growth of the inferior original centre of the bone, which may, in addition, have been situated slightly posterior to the upper centre.
The division in the right parietal of the chimpanzee begins at its anterior end, and runs for the first third of its course in the same way as that on the left side; its posterior end, however, does not reach the lambdoid, but turns up and ends in the sagittal border. Should this formation have existed alone, I should be inclined to consider it either as the result of an accessory centre of the parietal, or, possibly, as a persistence of the anterior portion of the divided superior centre of the bone, the posterior portion of the same being united with the lower segment of the parietal in the usual way. With the division of the left parietal in the same skull before me, everything points to a similar origin of the division on both sides, and to the right as well as the left division being a true "parietal suture," deflected less on the left and more on the right side by a disproportion in growth of the two original, regular segments of each of the bones.
The disproportion of growth of the two original segments of the parietal bone will, I believe, be found more common as attention is directed to this subject. It can be well explained, though there may at times be other factors present, by a difference in the blood-supply to the two centres. This of course may occur not only in different skulls, but also on the two sides of the same cranium.
Footnotes:
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A Bilateral Division of the Parietal Bone in a Chimpanzee · The Wunder Library — complete classics, free to read, with narration.