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Surgical Anatomy of the Scalp

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Brain Anatomy and Neurosurgical Approaches

Abstract

The craniofacial region is fundamental for the aesthetic harmony of the human body. Based on this assumption, the aesthetic results after neurosurgical interventions should be considered. As well as advances in surgical techniques, patients also demand that cosmetics not be compromised.

Among the skills required in neurosurgery is that craniotomy must be planned so that the intracranial approach should be safe and effective. An inadequate incision can compromise the entire surgical act. The first step in this process is the anatomical knowledge of vascularization, scalp innervation, and the possibility of hiding the scar. If this is not possible, minimizing aesthetic defects are an essential step in any neurosurgical approach.

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References

  1. Figueiredo EG, Welling LC, Preul MC, Sakaya GR, Neville I, Spetzler RF, et al. Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms. J Clin Neurosci. 2016;27:34–9.

    Article  PubMed  Google Scholar 

  2. Welling LC, Figueiredo EG, Wen HT, Gomes MQT, Bor-Seng-Shu E, Casarolli C, et al. Prospective randomized study comparing clinical, functional, and aesthetic results of minipterional and classic pterional craniotomies. J Neurosurg. 2015;122(5):1012–9.

    Article  PubMed  Google Scholar 

  3. Welling LC, Figueiredo EG. Temporal muscle atrophy: not only the approach but the way you get it. J Plast Reconstr Aesthet Surg. 2018;71(3):445–6.

    Article  PubMed  Google Scholar 

  4. Carmichael SW. The tangled web of Langer’s lines. Clin Anat. 2014;27(2):162–8.

    Article  PubMed  Google Scholar 

  5. Thomaidis VK. Scalp and temple. In: Cutaneous flaps in head and neck reconstruction. Berlin: Springer; 2014. p. 13–76. https://doi.org/10.1007/978-3-642-41254-7_2.

    Chapter  Google Scholar 

  6. Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 40th ed. Edinburg: Churchill Livingstone/Elsevier; 2008.

    Google Scholar 

  7. Hayman AL, Shukla V, Ly C, Taber KH. Clinical and imaging anatomy of the scalp. J Comput Assist Tomogr. 2003;27(3):454–9.

    Article  PubMed  Google Scholar 

  8. Tremolada C, Candiani P, Signorini M, Vigano M, Donati L. The surgical anatomy of the subcutaneous fascial system of the scalp. Ann Plast Surg. 1994;32(1):8–14.

    Article  CAS  PubMed  Google Scholar 

  9. Casanova R, Cavalcante D, Grotting JC, Vasconez LO, Psillakis JM. Anatomic basis for vascularized outer-table calvarial bone flaps. Plast Reconstr Surg. 1986;78(3):300–8.

    Article  CAS  PubMed  Google Scholar 

  10. Jeong SM, Park KJ, Kang SH, Shin HW, Kim H, Lee HK, et al. Anatomical consideration of the anterior and lateral cutaneous nerves in the scalp. J Korean Med Sci. 2010;25(4):517.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hwang K, Suh MS, Lee SI, Chung IH. Zygomaticotemporal nerve passage in the orbit and temporal area. J Craniofac Surg. 2004;15(2):209–14.

    Article  PubMed  Google Scholar 

  12. Cohen-Gadol A, Kemp W III, Tubbs RS. The innervation of the scalp: a comprehensive review including anatomy, pathology, and neurosurgical correlates. Surg Neurol Int. 2011;2(1):178.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kemp WJ, Cohen-Gadol AA. A review of skin incisions and scalp flaps for the retromastoid approach and description of an alternative technique. Surg Neurol Int. 2011;2:143.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Tubbs RS, Fries FN, Kulwin C, Mortazavi MM, Loukas M, Cohen-Gadol AA. Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage. J Clin Neurosci. 2016;32:83–7.

    Article  PubMed  Google Scholar 

  15. Tubbs RS, Mortazavi MM, Loukas M, D’Antoni AV, Shoja MM, Chern JJ, et al. Anatomical study of the third occipital nerve and its potential role in occipital headache/neck pain following midline dissections of the craniocervical junction: laboratory investigation. J Neurosurg Spine. 2011;15(1):71–5.

    Article  PubMed  Google Scholar 

  16. Janis JE, Hatef DA, Ducic I, Reece EM, Hamawy AH, Becker S, et al. The anatomy of the greater occipital nerve: part II. Compression point topography. Plast Reconstr Surg. 2010;126(5):1563–72.

    Article  CAS  PubMed  Google Scholar 

  17. Zani R, Fadul R, Dias Da Rocha MA, Santos RA, Alves MCA, Ferreira LM. Facial nerve in rhytidoplasty: anatomic study of its trajectory in the overlying skin and the most common sites of injury. Ann Plast Surg. 2003;51(3):236–42.

    Article  PubMed  Google Scholar 

  18. Pitanguy I, Ramos AS. The frontal branch of the facial nerve: the importance of its variations in face lifting. Plast Reconstr Surg. 1966;38(4):352–6.

    Article  CAS  PubMed  Google Scholar 

  19. Tayfur V, Edizer M, Magden O. Anatomic bases of superficial temporal artery and temporal branch of facial nerve. J Craniofac Surg. 2010;21(6):1945–7.

    Article  PubMed  Google Scholar 

  20. Chen TH, Chen CH, Shyu JF, Wu CW, Lui WY, Liu JC. Distribution of the superficial temporal artery in the Chinese adult. Plast Reconstr Surg. 1999;104(5):1276–9.

    Article  CAS  PubMed  Google Scholar 

  21. Marano SR, Fischer DW, Gaines C, Sonntag VKH. Anatomical study of the superficial temporal artery. Neurosurgery. 1985;16(6):786–90.

    Article  CAS  PubMed  Google Scholar 

  22. Pinar YA, Govsa F. Anatomy of the superficial temporal artery and its branches: its importance for surgery. Surg Radiol Anat. 2006;28(3):248–53.

    Article  PubMed  Google Scholar 

  23. Edizer M, Beden U, Icten N. Morphological parameters of the Periorbital arterial arcades and potential clinical significance based on anatomical identification. J Craniofac Surg. 2009;20(1):209–14.

    Article  PubMed  Google Scholar 

  24. Gantwerker EA, Hom DB. Skin: histology and physiology of wound healing. Facial Plast Surg Clin N Am. 2011;19(3):441–53.

    Article  Google Scholar 

  25. Santos CMT, Pereira CU, Chaves PHS, de Lima Tôrres PTR, da Paixão Oliveira DM, Rabelo NN. Options to manage postcraniotomy acute pain in neurosurgery: no protocol available. Br J Neurosurg. 2021;35(1):84–91.

    Article  PubMed  Google Scholar 

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Welling, L.C., Rabelo, N.N., Figueiredo, E.G. (2023). Surgical Anatomy of the Scalp . In: Figueiredo, E.G., Rabelo, N.N., Welling, L.C. (eds) Brain Anatomy and Neurosurgical Approaches . Springer, Cham. https://doi.org/10.1007/978-3-031-14820-0_2

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  • DOI: https://doi.org/10.1007/978-3-031-14820-0_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-14819-4

  • Online ISBN: 978-3-031-14820-0

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