NEUROSURGERY Dr. Walid Al-Mekhlafi 2023 Anatomy Scalp Skull Intracranial injuries Hydrocephalus Brain abscess Intracranial tumors ANATOMY SCALP • The scalp is composed of 5 layers • It is very richly supplied by blood vessels, so wounds heal nicely without infection • If injured, the scalp bleeds profusely • The loose areolar tissue allows accumulation of large amounts of blood Wounds of the scalp could be: • Hematomas • Lacerations • Incisions • Contusions SKULL Fractures of the skull could be either: 1. Fractures of the vault 2. Fractures of the base • Anterior fossa • Middle fossa • Posterior fossa • Fractures of the vault could be depressed or fissure • They could be either closed or open (compound) • Opened fractures are associated with CSF leakage and prolapse of portion of the brain Complications of depressed fractures? • Fractures of the base are due to indirect violence caused by falls • Fractures of the base of the skull are associated with injury to all cranial nerves except the twelfth (Hypoglossal N.) Anterior cranial fossa is associated with epistaxis, rhinorrhea and racoon sign (extravasation of blood) Middle cranial fossa is associated with otorrhea, escape of blood and battle’s sign Posterior cranial fossa is associated with cranial nerve injury 9,10,11