The middle meningeal artery ('' la, arteria meningea media'') is typically the third branch of the first portion of the

maxillary artery The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible. Structure The maxillary artery, the larger of the two terminal branches of the external carotid artery, ...

. After branching off the maxillary artery in the infratemporal fossa, it runs through the

foramen spinosum The foramen spinosum is a hole located in the greater wing of the sphenoid. It is located posterolateral to the foramen ovale and anterior to the sphenoidal spine. It allows the passage of the middle meningeal artery, middle meningeal vein and ...

to supply the

dura mater In neuroanatomy, dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord. It is the outermost of the three layers of membrane called the meninges that protect the central nervous system. ...

(the outer meningeal layer) and the calvaria. The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges, the others being the anterior meningeal artery and the

posterior meningeal artery The posterior meningeal artery is the largest vessel supplying the dura region of the posterior fossa. It typically arises from the ascending pharyngeal artery although other origins have been seen, such as the occipital artery. The artery or its b ...

. The anterior branch of the middle meningeal artery runs beneath the

pterion The pterion is the region where the frontal, parietal, temporal, and sphenoid bones join. It is located on the side of the skull, just behind the temple. Structure The pterion is located in the temporal fossa, approximately 2.6 cm beh ...

. It is vulnerable to injury at this point, where the skull is thin. Rupture of the artery may give rise to an

epidural hematoma Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull. Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciou ...

. In the dry

cranium The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, the ...

, the middle meningeal, which runs within the dura mater surrounding the

brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a v ...

, makes a deep groove in the calvarium. The middle meningeal artery is intimately associated with the

auriculotemporal nerve The auriculotemporal nerve is a branch of the mandibular nerve (CN V3) that runs with the superficial temporal artery and vein, and provides sensory innervation to various regions on the side of the head. Structure Origin The auriculotempor ...

, which wraps around the artery making the two easily identifiable in the

dissection Dissection (from Latin ' "to cut to pieces"; also called anatomization) is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause o ...

of human cadavers and also easily damaged in

surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

Structure

It ascends between the

sphenomandibular ligament The sphenomandibular ligament (internal lateral ligament) is one of the three ligaments of the temporomandibular joint. It is situated medially to - and generally separate from - the articular capsule of the joint. Superiorly, it is attached to the ...

and the

lateral pterygoid muscle The lateral pterygoid muscle (or external pterygoid muscle) is a muscle of mastication. It has two heads. It lies superior to the medial pterygoid muscle. It is supplied by pterygoid branches of the maxillary artery, and the lateral pterygoid ne ...

, and between the two roots of the

to the

of the sphenoid bone, through which it enters the

; it then runs forward in a groove on the great wing of the sphenoid bone, and divides into two branches, anterior and posterior. The ''anterior branch'', the larger, crosses the great wing of the sphenoid, reaches the groove, or canal, in the sphenoidal angle of the

parietal bone The parietal bones () are two bones in the skull which, when joined at a fibrous joint, form the sides and roof of the cranium. In humans, each bone is roughly quadrilateral in form, and has two surfaces, four borders, and four angles. It is nam ...

, and then divides into branches that spread out between the dura mater and internal surface of the cranium, some passing upward as far as the

vertex Vertex, vertices or vertexes may refer to: Science and technology Mathematics and computer science *Vertex (geometry), a point where two or more curves, lines, or edges meet * Vertex (computer graphics), a data structure that describes the positio ...

, and others backward to the

occipital The occipital bone () is a cranial dermal bone and the main bone of the occiput (back and lower part of the skull). It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone overlies the occipital lobes of the cereb ...

region. The ''posterior branch'' curves backward on the squamous part of the

temporal bone The temporal bones are situated at the sides and base of the skull, and lateral to the temporal lobes of the cerebral cortex. The temporal bones are overlaid by the sides of the head known as the temples, and house the structures of the ears. Th ...

, and, reaching the parietal bone some distance in front of its mastoid angle, divides into branches that supply the posterior part of the dura mater and cranium. The branches of the middle meningeal artery are distributed partly to the dura mater, but chiefly to the bones; they anastomose with the arteries of the opposite side, and with the anterior and posterior meningeal arteries. The very smallest distal branches

anastomose An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams. Such a connection may be normal ...

through the

skull The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, th ...

with small arterioles from the

scalp The scalp is the anatomical area bordered by the human face at the front, and by the neck at the sides and back. Structure The scalp is usually described as having five layers, which can conveniently be remembered as a mnemonic: * S: The ski ...

. On entering the cranium, the middle meningeal artery gives off the following branches: # Numerous small vessels supply the

trigeminal ganglion A trigeminal ganglion (or Gasserian ganglion, or semilunar ganglion, or Gasser's ganglion) is the sensory ganglion at the base of each of the two trigeminal nerves (CN V), occupying a cavity ( Meckel's cave) in the dura mater, covering the trige ...

and the

# A superficial petrosal branch enters the

hiatus of the facial canal The hiatus for the greater petrosal nerve is a small hole in the petrous part of the temporal bone which connects the facial canal to the middle cranial fossa. The greater petrosal nerve travels through it to branch from the facial nerve and reac ...

, supplies the

facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of tas ...

, and anastomoses with the

stylomastoid branch The stylomastoid artery enters the stylomastoid foramen and supplies the tympanic cavity, the tympanic antrum and mastoid cells, and the semicircular canals. It is a branch of the posterior auricular artery, and thus part of the external carotid ...

of the

posterior auricular artery The posterior auricular artery is a small artery that arises from the external carotid artery, above the digastric muscle and stylohyoid muscle, opposite the apex of the styloid process. It ascends posteriorly beneath the parotid gland, along t ...

. # A superior tympanic artery runs in the canal of the

tensor tympani The tensor tympani is a muscle within the middle ear, located in the bony canal above the bony part of the auditory tube, and connects to the malleus bone. Its role is to dampen loud sounds, such as those produced from chewing, shouting, or th ...

muscle, and supplies this muscle and the lining of the canal. # Orbital branches pass through the superior orbital fissure or through separate canals in the

great wing of the sphenoid The greater wing of the sphenoid bone, or alisphenoid, is a bony process of the sphenoid bone; there is one on each side, extending from the side of the body of the sphenoid and curving upward, laterally, and backward. Structure The greater wi ...

, to anastomose with the lacrimal or other branches of the

ophthalmic artery The ophthalmic artery (OA) is an artery of the head. It is the first branch of the internal carotid artery distal to the cavernous sinus. Branches of the ophthalmic artery supply all the structures in the orbit around the eye, as well as some s ...

. # Temporal branches pass through foramina in the

, and anastomose in the

temporal fossa The temporal fossa is a fossa (shallow depression) on the side of the skull bounded by the temporal lines and terminating below the level of the zygomatic arch. Boundaries * Medial: frontal bone, parietal bone, temporal bone, and sphenoid bon ...

with the

deep temporal arteries The deep temporal arteries are two arteries of the head. They ascend between the temporalis muscle and the pericranium. They anastomose with the middle temporal artery, among other vessels. They supply the temporalis muscle. Structure The deep ...

Variation

In approximately half of subjects it branches into an

accessory meningeal artery The accessory meningeal artery (also accessory branch of middle meningeal artery, pterygomeningeal artery, small meningeal or parvidural branch) is a branch of the maxillary artery, sometimes derived from the middle meningeal artery. Course It ent ...

. Very rarely the

may arise as a branch of the middle meningeal artery. The middle meningeal artery may arise not only from the

but also from the

, or

lacrimal artery The lacrimal artery is an artery of the orbit. It is a branch of the ophthalmic artery. It accompanies the lacrimal nerve along the upper border of the lateral rectus muscle, travelling forward to reach the lacrimal gland. It supplies the lacri ...

Clinical relevance

An injured middle meningeal artery is the most common cause of an

. A head injury (e.g., from a road traffic accident or

sports injury Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three m ...

) is required to rupture the artery. Emergency treatment requires decompression of the haematoma, usually by

craniotomy A craniotomy is a surgical operation in which a bone flap is temporarily removed from the skull to access the brain. Craniotomies are often critical operations, performed on patients who are suffering from brain lesions, such as tumors, blood clot ...

. Subdural bleeding is usually ''venous'' in nature, rather than arterial. The middle meningeal artery runs in a groove on the inside of the

. This can clearly be seen on a lateral skull

X-ray An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...

, where it may be mistaken for a fracture of the skull. On a dry specimen, the groove is easy to see. This means that the artery is easy to study, even in specimens centuries old, and several classifications of the branches have been proposed, e.g. Adachi's classification of 1928.

History

Additional images

Image:Gray133.png, Left parietal bone. Inner surface. Image:Gray138.png, Left temporal bone. Inner surface. Image:Gray193.png, Base of the skull. Upper surface. Image:Gray778.png, Distribution of the maxillary and mandibular nerves, and the submaxillary ganglion. Image:Gray783.png, The otic ganglion and its branches. Image:Gray789.png, The course and connections of the facial nerve in the temporal bone. Image:Human brain dura mater description.JPG, Human brain dura mater

References

External links

* * ()
Photos with captions at bubbasoft.org
{{Authority control Arteries of the head and neck