The bregma is the junction point of the coronal suture (between frontal and parietal bones) and the sagittal suture (between the two parietal bones) on the top of the skull. It corresponds to the site of the anterior fontanelle in infants, which closes between 12-18 months of age. In adults it is a palpable intersection point on the vault, approximately 13 cm behind the nasion.
The bregma and anterior fontanelle are clinical landmarks in infants: a bulging fontanelle indicates raised intracranial pressure; a sunken fontanelle indicates dehydration. Fontanelle palpation guides cranial ultrasound for neonatal brain imaging. In forensic anthropology, the bregma is a key craniometric point for skull measurement. In neurosurgery and EEG, the bregma defines the vertex (Cz) electrode position in the 10-20 system.
Raised intracranial pressure from meningitis, hydrocephalus, or intracranial haemorrhage produces a tense or bulging anterior fontanelle at the bregma in infants before cranial suture closure, a clinical sign prompting immediate lumbar puncture assessment or CT before LP if mass lesion is suspected.
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