THE SCALP. 



Varicose aneurism is where a sac intervenes between the artery and vein, so 

 that the blood passes first from the artery into the sac and then into the vein. The 

 temporal artery with its companion vein has been so affected. 



Treatment of Vascular Affections of the Scalp. Vascular tumors are 

 usually ligated and excised. Acupressure pins may be passed under the larger 

 arterial trunks, but the exceedingly free anastomosis renders thorough excision 

 preferable; even this is not seldom unsuccessful. 



TUMORS OF THE SCALP. 



Sebaceous cysts arise from obstructed sebaceous glands; the contents consists of 

 epithelial cells, fat, and cholesterin. They sometimes calcify. They spread in the 

 subcutaneous tissue, stretching and raising the skin above and causing atrophy of 



FIG. 9. Sebaceous cyst of scalp. 



FIG. :o. Meningocele. 



the hair bulbs, but do not involve the epicranial aponeurosis below. In removing 

 them, if they have never been inflamed, they can readily be turned out through a 

 slit in the skin. The subaponeurotic space will not - be opened, therefore their 

 removal is not often followed by bad results. 



Encephalocele is a tumor formed by a protrusion, through the skull, of the 

 membranes of the brain, containing brain matter and cerebrospinal fluid. 



Meningocele, or a tumor containing the meninges of the brain and cerebrospinal 

 fluid, is more rare in the skull than is the case when the spine is affected. It pro- 

 trudes through an unossified part of the skull, and, according to Sutton, two-thirds of 

 the cases occur in the occipital region, between the foramen magnum and torcular 

 Herophili. He characterizes it as a hydrocele of the fourth ventricle, and says that 

 nine out of ten cases die if operated on. The next most frequent seat for meningo- 

 cele is at the root of the nose (Fig. 10). 



Cephalhydrocele is the name given to a pulsating tumor communicating with the 

 interior of the skull through a traumatic opening. It contains cerebrospinal fluid. 



Dermoid tumors occur in the median line and, according to Sutton, are most 

 common over the anterior fontanelle and external occipital protuberance. They often 

 have a thin pedicle attaching them to the dura mater and may grow either inside or out- 

 side the skull. They are formed by an inclusion of some of the tissue of the ectoderm 

 by the bones as they approach from each side to ossify and unite in the median line. 



A congenital tumor located at the root of the nose is probably an encephalocele; 

 one located at the anterior fontanelle is probably a dermoid; a tumor in the occipital 

 region may be either, but a dermoid is apt to be higher up than an encephalocele. 



