Definition Distance from the root of the nose (nasion) to the highest point of the head (vertex).
Landmarks Measure from the depth of the nasal root to the superior-most point of the skull in the vertical plane (Figs. 7.1 and 7.11).
Instruments Spreading calipers are most accurate. A tape-measure could be used, being held vertically and avoiding the natural curve of the head.
Position The head should be held erect (in the resting position) with the eyes looking straight forward. The patient should face the examiner.
Alternative The patient may face perpendicular to the examiner.
Remarks Charts of normal skull height are presented in Fig. 7.12. Alteration in skull shape will produce marked variation in this measurement. For example, turricephaly will increase the skull height. X-ray measurements are more precise.
Pitfalls A prominent nasal root may make definition of the nasion difficult and reduce the accuracy of this measurement. If the nasion is poorly defined, measure from a point on the nose at the level of the inner canthi. The vertex is not identical to the bregma, the bony landmark in the middle of the top of the skull where the coronal and sagittal sutures cross.
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