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Related Experiment Video

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Hairline as a Neurosurgical Landmark.

Oleg Titov1, Igor Pronin2

  • 1Department of Neurosurgery, Moscow Multidisciplinary Clinical Center "Kommunarka", Moscow, RUS.

Cureus
|April 29, 2026
PubMed
Summary

The hairline topography correlates with deep cranial structures, offering new landmarks for neurosurgery. This study reveals consistent hairline patterns related to over 20 neuroanatomical features, aiding surgical planning.

Keywords:
anatomic landmarkscraniometric pointshairlineneuroanatomyneuroimagingneuronavigationneurosurgerytrichology

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Area of Science:

  • Anatomy
  • Neurosurgery
  • Medical Imaging

Background:

  • The relationship between hairline topography and deeper neuroanatomical structures remains largely unexplored.
  • Trichology indicates relatively constant hairline patterns, suggesting potential for anatomical correlation.
  • Existing craniometric landmarks may not fully capture the detailed topography relevant to modern neurosurgical approaches.

Purpose of the Study:

  • To analyze hairline topography in relation to underlying neuroanatomical structures.
  • To determine the accuracy and representativeness of newly identified hairline landmarks.
  • To establish novel anatomical terminology for precise hairline segmentation and analysis.

Main Methods:

  • Prospective study involving 520 patients across two groups.
  • Radiopaque wire fixation along the hairline followed by CT angiography (CTA) and MRI in a subset of 20 patients.
  • 3D visualization and detailed topographic analysis using novel anatomical terminology for landmark identification.

Main Results:

  • A clear topographic relationship was identified between the hairline and over 20 cranial, cerebral, and vascular structures.
  • Established hairline landmarks accurately localized sutures, ridges, vertebrae, cortical sulci, gyri, and vessels (e.g., superficial temporal artery, transverse-sigmoid sinus junction).
  • Discovered landmarks demonstrated clinically acceptable spatial accuracy (6.9±3.3 mm shift) and high representativeness (85-100% constancy across regions and sexes).

Conclusions:

  • The hairline is topographically connected to deep cranial layers, serving as a reliable surface indicator.
  • Novel hairline landmarks provide valuable data for planning neurosurgical approaches.
  • These findings complement standard craniometric landmarks and neuronavigation systems, enhancing surgical precision.