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The galea aponeurotica (also called the galeal or epicranial aponeurosis or the aponeurosis epicranialis) is a tough fibrous sheet of connective tissue that extends over the cranium, forming the middle (third) layer of the scalp.
The galea aponeurotica also contains vessels that communicate between the deep vascular plexus contained within the subgaleal layer below as well as the superficial vascular plexus in the subcutaneous layer above 2.
anterior auricular muscle
superior auricular muscle
Collections of the scalp that sit deep to the galea aponeurotica in the subgaleal space have the potential to drain anteriorly from the scalp into the eyelids 2. This is seen in cases of periorbital hematoma following scalp trauma or surgery in which blood passes anteriorly deep to the galea aponeurotica.
A subgaleal hematoma is a rare but potentially lethal emergency, most commonly associated with vacuum or forceps delivery. An effected newborn can quickly lose up to 70% of their circulating blood volume which can rapidly progress to hypovolemic shock, anemia, coagulopathy and death.