Anatomy of head injury

详细信息    查看全文

• 作者：Harold Ellis
• 关键词：Arachnoid ; blood supply ; extradural haematoma ; meninges &ndash ; dura ; pia mater ; scalp layers ; subdural haematoma
• 刊名：Surgery (Oxford)
• 出版年：2012
• 出版时间：March, 2012
• 年：2012
• 卷：30
• 期：3
• 页码：99-101
• 全文大小：325 K

文摘

The scalp has an extremely rich blood and nerve supply. It comprises five layers - skin, connective tissue, aponeurosis, loose areolar tissue and periosteum. The blood vessels lie within the tough fibrous septa of the connective tissue layer and cannot retract when divided - hence the copious bleeding from a scalp laceration. The loose areolar tissue beneath the aponeurosis is the plane in which the scalp is avulsed in trauma and in which the surgeon mobilizes a scalp flap. The periosteum adheres to the suture lines of the skull and a haematoma in this plane outlines the affected skull bone (cephalohaematoma).

The meninges comprise the outer tough dura mater to which adheres the arachnoid mater, while the pia mater adheres to the underlying cerebral tissue. An extradural haematoma results from laceration of one of the meningeal vessels, (especially the middle meningeal), a torn sagittal sinus or from oozing of the diploeic vessels of the skull. The underlying brain is often relatively intact and early surgery has a good prognosis. In contrast, an acute subdural haematoma results from a cerebral laceration. A chronic subdural hygroma may follow a relatively trivial injury which tears a small cerebral vein traversing the subdural space.