Corpus: Scalp

The scalp is a coarse and very resistant tissue composite of scalp, subcutis and tendon cap (Galea aponeurotica), which is stretched over the skullcap.

The scalp has a thickness of about 4 to 5 mm in adults. The tendon cap of the cranial vault is connected to the periosteum of the skull bones (pericranium) via loose connective tissue and thus allows a certain degree of mobility of the cranial vault - e.g. through the muscle tension of the epicranial muscles.

2.1. Vascular supply

The arterial supply to the scalp is mainly via the temporal artery and the occipital artery. The superficial temporal vein, the occipital vein, the posterior auricular vein and the retromandibular vein are involved in the venous drainage. These veins communicate with the cerebral sinuses inside the skull via diploevenes.

2.2. Nerves

The sensory supply of the scalp is mediated by the following nerves:

• Frontal nerve
• Auriculotemporal nerve
• Major occipital nerve
• Minor occipital nerve

Direct violence to the skull usually leads to head lacerations. The good vascularisation of the scalp ensures impressive bleeding in relation to the actual size of the wound. Scalp lacerations are treated surgically by suturing the wound.

Oedema or haematomas in the area of the scalp occur with perinatal injuries during birth or as part of a traumatic brain injury. Depending on the localisation, a distinction is made between

• Caput succedaneum: subcutaneous above the galea aponeurotica
• Subgaleal haematoma: between the galea and pericranium
• Cephalhaematoma: subperiosteal between the pericranium and the cranial bone. Limited by the sutures.

The English acronym SCALP serves as a mnemonic for the structure of the cephalic ridge:

• S - skin
• C - dense connective tissue
• A - epicranial aponeurosis
• L - loose areolar connective tissue
• P - periosteum