“A Clinicoanatomical Study of Shanka Marma�...

“A Clinicoanatomical Study of Shanka Marma”

Author Name : Dr. Satendra Kumar Dubey

ABSTRACT

Shankh marma is located above the bhrupuchhu in between karn and lalat with half angul measue ment  and   structurally  it is  Asthi Marma and  post traumatic effect is  immediate death,  prognostic status is sadyapranhara .  after discussion we concluded  that area is correlated with temple region  specially over Pterion sites  where the   middle meningeal artery  enters the cranial cavity  through the foramen spinosum .It runs in an anterolateral groove  on the squmaus part of temporal bone in Pterion point  dividing into  frontal  and parietal  branches. Pterion point is vulnerable to injury where the temple region is thin. Any trauma of temple region leads  to laceration of the middle meningeal artery which may give rise to an epidural hematoma which if  expands then strips the dura from the inside of the skull, causing an intense headache. If the size of hematoma become large then raises intracranial pressure, obstruct the blood supply & causing the brain to shift or be crushed against the skull. If we receive surgery quickly then the outcome will be surely good. If injured the brain may be damage more at temple region anatomically because of prominences on the inside of the skull. Epidural hematoma is usually found over the same area of the brain & therefore is more fatal. In critical study there is no doubt left about the vulnerability of’ Pterion’ which is situated in the region of temple. Though the cause of emergency is bleeding from middle meningeal artery but classics have upheld the Asthi to be responsible for this condition. The study reveals that the Anterior & posterior branch of middle meningeal artery sheltered by temporal bone due to irregular H shaped suture at the point of Pterion & the thinness of the bone convert this region into a weak area, so Acharya  sushrut  told  shankha Marma is Asthi Marma.