Middle Meningeal Artery

The middle meningeal artery is important to the surgeon because this artery is the commonest source of 

extradural haemorrhage, which is an acute surgical emergency

The artery is a branch of the first part of the maxillary artery, given off in the infratemporal fossa 

Course ond Relations

1. In the infratemporal fossa, the artery runs upwards and medially deep to the lateral pterygoid muscle and superficial to the sphenomandibular ligament.

Here it passes through a loop formed by the two roots of the auriculotemporal nerve.

2. It enters the middle cranial fossa through the foramen spinosum

3. In the middle cranial fossa, the artery has an extradural course, but the middle meningeal veins are closer to the bone than the artery. 

Here the artery runs forwards and laterally for a variable distance, grooving the squamous temporal bone, and divides into a frontal and parietal branch 

4. The frontal or anterior branch is larger than the parietal branch. 

First it runs forwards and laterally towards the lateral end of the lesser wing of the sphenoid. Then it runs obliquely upwards and backwards, parallel to, and a little in front of the central sulcus of the cerebral hemisphere. 

Thus after crossing the pterion, the artery is closely related to the motor area of the cerebral cortex.

5. The parietal or posterior branch runs backwards over, or near, the superior temporal sulcus of the cerebrum, about 4 cm above the level of the zygomatic arch. 

It ends in front of the posteroinferior angle of the parietal bone by dividing into branches.

Branches

The middle meningeal artery supplies only small branches to the dura mater. 

It is predominantly a periosteal artery supplying bone and red bone marrow in the diploe.

Within the cranial cavity, it gives off:

a. The ganglionic branches to the trigeminal ganglion.

b. A petrosal branch to the hiatus for the greater petrosal nerve.

c. A superior tympanic branch to the tensor tympani.

d. Temporal branches to the temporal fossa.

e. Anastomotic branch that enters the orbit and anastomoses with the lacrimal artery

Clinical Anatomy

• The middle meningeal artery is of great surgical importance because it can be torn in head injuries resulting in extradural haemorrhage. 
• The frontal or anterior branch is commonly involved. 
• The haematoma presses on the motor area, giving rise to hemiplegia of the opposite side. 
• The anterior division can be approached surgically by making a hole in the skull over the pterion, 4 cm above the midpoint of the zygomatic arch.
• Rarely, the parietal or posterior branch is implicated, causing contralateral deafness. In this case, the hole is made at a point 4 cm above and 4 cm behind the external acoustic meatus

Watch lectures on YouTube:

Middle Meningeal Artery | Accessory Meningeal Artery - Course | Branches | Distribution |