Surgical anatomy of the subgaleal fascia of the scalp and its arterial vasculature

ABSTRACT

The surgical anatomy of the fascial layers and vascularization of the scalp was studied by dissecting ten adult cadavers and two still births. This article is organized as follows first, a description of the layers and fasciae of the scalp and their relationships with the main vascular structures. Then special attention was directed to the layer of "loose connective tissue" that lies beneath the entire galea and above the cranial periosteum centrally, and the temporalis fascia laterally. It has been named the "subgaleal fascia" which is discrete anatomical entity, thin, malleable and well vascularized. A description of the histological structure of the subgaleal fascia "composed of multiple connective vascularized sheets loosely adherent to one another". Cadaveric dissections revealed its blood supply from the principal vascular pedicles of the scalp [axial blood supply] and from major perforant vessels to the subgaleal fascia as follows in the temporal region, perforant vessels from the superficial temporal artery near and about ten centimeter above zygomatic arch, and in the fronto-parieto-occipital region, many small perforant vessels evenly entering the subgaleal fascia every five to ten mm. These findings could lead to greater use of fascial or composite flaps from the scalp region