Abstract

Cranial sutures are not of great concern to the modern neurosurgeon, except when abnormalities interfere with the skull's shape and its ability to expand during childhood. It is a commonplace that a craniotomy may cross a variety of sutures without providing any extra difficulty to the operator. The sagittal suture does remain useful as a definition of the midline of the cranium and as an indicator of the underlying sinus. Galen for reasons that are far from clear, "observed" relationships between the sutures, the meninges and the pericranium which led him to advise avoidance of any surgical proximity to the sutures. The result of this proscription was a severe limit of the access surgeons considered was appropriate and thus limited their ability to care for their patients.

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