Publication History

Abstract

The soft tissue covering the cranial vault forms the scalp. Which extends from supra orbital margins, anteriorly; external occipital protuberance and superior nuchal lines, posteriorly; and superior temporal lines laterally (Figure 1), (Krishna, 2010). SCALP is made up of five layers (Figure 2), (Yaremchuk, 2006) each word stand for one layer: (1) Skin, which is thick and hairy (Yaremchuk, 2006). It is adherent to the epicranial aponeurosis through the dense superficial fascia. Because of abundance of sebaceous glands, scalp is the common site for sebaceous cysts. (2) Subcutaneous tissue (Yaremchuk, 2006) and superficial fascia is fibrous and dense in the centre than at the periphery and binds skin to subjacent aponeurosis, and provides the proper medium for the passage of the vessels and nerves to skin. Scalp is very rich in blood supply and wounds of scalp bleeds profusely because the torn vessels are prevented from retracting by the fibrous fascia. Bleeding can be arrested by applying pressure against the bone. Because of density of fascia, subcutaneous hemorrhages are never extensive and inflammation in the layer cause little swelling but much pain. (3) Deep fascia in form of epicranial aponeurosis or galea aponeurotica with the occipitofrontalis muscle. Wounds of the scalp don’t gap unless aponeurosis is divided transversely. (4) Loose areolar tissue, it extends anteriorly into the eyelids as frontalis muscle does not have bony attachment. It is also known as dangerous area of scalp as emissary veins form here may transmit infection to cranial venous sinuses. Any collection here causes generalized swelling of scalp and blood may extend into root of none and eye lids causing black eye (Racoons eye). (5) Pericranium is loosel