Middle meningeal artery

Course

The middle meningeal artery is the largest of meningeal arteries. It typically arises in theinfratemporal fossa, as the third branch from the first part of the maxillary artery.

Sometimes, however, it can arise as a branch of the ophthalmic artery, or in rare cases as a branch of the basilar artery.

From its origin, the artery courses lateral to the tensor veli palatini muscle and enters the skull passing through the foramen spinosum. After entering the middle cranial fossa, it runs briefly onto the greater wing of the sphenoid bone, and divides into the frontal and parietal divisions.

Branches and supply

Before dividing into two terminal branches, the middle meningeal artery gives off the petrosal branch. The petrosal branch in turn, gives off the superior tympanic and the cavernous branch.

The middle meningeal artery terminates by dividing into anterior and posterior branches;

• The larger anterior branch (also known as the frontal division) passes across the greater wing of the sphenoid bone and enters the sphenoparietal canal. The anterior gives the medial branch or sphenoidal branch and the orbital branch.
• The smaller posterior branch (parietal division) courses posteriorly across the squamous part of the temporal bone, reaching the lower margin of the parietal bone. The posterior gives the petrosquamosal branch and the parieto-occipital branch.

Both the anterior and the posterior branches give the falcine branches that supply blood for the falx cerebri.

Learn everything about the arteries of the head seen from the lateral view with our study unit: 

Anatomical variations

The middle meningeal artery has a complex embryological origin, which gives rise to many anatomic variations of the artery. It is important to be aware of these variations in order to reduce the risk of iatrogenic injuries and surgical complications. Because the variations of this artery are not rare, some kind of radiographic visualization is recommended before the surgical procedure. 

The middle meningeal artery can originate from the internal carotid artery and specifically from the ophthalmic artery. In this case, the artery enters the skull via the carotid canal along with the internal carotid artery. In rare cases, the middle meningeal artery can also originate from other adjacent arteries such as the posterior cerebellar artery, basilar artery.

Clinical significance

Similar to the other meningeal vessels, the middle meningeal artery is closely related to the internal aspect of the skull. This can result in the rupture of the artery after a blunt force trauma. The rupture mainly occurs after the trauma in the lateral aspect of the skull near the area of the pterion, especially in children. In most cases, the clinical presentation of this rupture is an epidural hematoma. The typical clinical presentation of epidural hematoma is divided into three stages: loss of consciousness followed by a lucid interval and ending with rapid deterioration in neurological status. This type of injury usually requires surgical treatment.