Surgical anatomy of calvarial skin and bones--with particular reference to neurosurgical approaches.

Abstract

This chapter on surgical anatomy is addressed to young neurosurgeons and could be used as an introduction to basic neurosurgical technique. It aims to cover the basic anatomy relevant to making incisions in the scalp and creating bone flaps, an essential preliminary to any form of intracranial surgery. We will examine the anatomy of the scalp, its arterial and venous supply and its nervous system, as well as providing some technical points related to the cranial vault and the base of the skull. It will be explained how a well-grounded knowledge of the anatomical details makes it possible to execute correctly two of the most common approaches in neurosurgical practice, namely the pterional approach and an approach around the sinuso-jugular axis.