Middle meningeal artery

Topography and Vessel Pathway

The artery originates from the first (mandibular) segment of the maxillary artery (a. maxillaris), lying between the neck of the mandibular condyle and the stylomandibular ligament.

It courses superiorly and enters the cranial cavity through the foramen spinosum (foramen spinosum). Inside the cranial cavity, the artery branches over the squamous part of the temporal bone and the greater wing of the sphenoid bone, running along the outer surface of the dura mater. It is the largest of the meningeal arteries and supplies the entire lateral (convex) surface of the cranial vault.

Branches of the Middle Meningeal Artery

Within the cranial cavity, the vessel divides into the frontal branch (r. frontalis) and the parietal branch (r. parietalis), which run along the external surface of the dura mater.

In addition, the following branches arise from the trunk:

• Superior tympanic artery (a. tympanica superior) — runs toward the mucous membrane of the tympanic cavity.
• Petrosal branch (r. petrosus) — courses toward the canal for the greater petrosal nerve.
• Orbital branch (r. orbitalis) — runs toward the orbit.
• Pterygomeningeal artery (a. pterygomeningea) — heads toward the pterygoid muscles, auditory tube, and dura mater.
• Anastomotic branch with the lacrimal artery (r. anastomoticus cum a. lacrimali).

Anastomoses and Their Significance

The middle meningeal artery anastomoses within the orbit with the lacrimal artery (a. lacrimalis), which is a branch of the ophthalmic artery originating from the internal carotid artery.

Clinical significance: in occlusion of the ophthalmic artery proximal to the origin of the central retinal artery, retinal blood supply can be maintained via blood flow from the middle meningeal artery through this anastomosis. The anterior and posterior meningeal arteries also form anastomoses with the middle meningeal artery.

Projection onto the Skull (Krönlein's Craniometric Scheme)

Krönlein's craniometric scheme is used to localize the vessel:

• Arterial trunk: projected onto the intersection of the anterior vertical line (drawn through the midpoint of the zygomatic arch) and the lower horizontal line (drawn through the infraorbital margin and the upper margin of the external acoustic meatus). This point is located at the upper margin of the zygomatic arch, 2.0–2.5 cm posterior to the frontal process of the zygomatic bone.
• Frontal branch: projected onto the intersection of the anterior vertical line with the upper horizontal line.
• Parietal branch: projected onto the intersection of the posterior vertical line with the upper horizontal line.

Clinical Significance and Trauma

• Epidural hematomas: in traumatic brain injuries, the middle meningeal artery or its branches are the source of bleeding in 80% of cases.
• Risks during anesthesia: the vessel can be injured during regional anesthesia of the mandibular nerve (V3) at the foramen ovale.
• Surgery: during decompressive craniectomy, enlarging the burr hole in an anteroinferior direction carries the risk of damaging the arterial trunk. If the vessel is injured, its peripheral end is ligated with a transfixing suture, while the central end, located within the bone canal, is sealed with bone wax.

Class and exam questions

What else to study on this topic

• Maxillary artery (a. maxillaris)
• Dura mater
• Krönlein's craniometric scheme
• Epidural hematoma

Other topics in the "Anatomical Structures" section

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.