Middle Meningeal Artery

The Middle meningeal artery (from Latin arteria meningea media, where meninx means the meninges) is the largest blood vessel supplying arterial blood to the dura mater and the bones of the Calvaria.

Damage to this artery is the main cause of the formation of life-threatening acute epidural hematomas.

Etiology and pathophysiology

This powerful vessel is a branch of the maxillary artery and enters the cranial cavity through a small foramen at its base. Once inside, the artery branches into an extensive network, passing through the narrow epidural space – strictly between the dura mater and the bone.

The most vulnerable segment is the anterior branch of the artery. It passes along the inner surface of the squama of the temporal bone in an area called the pterion. This is the thinnest and most fragile area of the entire calvaria. Here, the artery is not merely adjacent to the bone, but is often physically embedded in a deep bony groove, depriving the vessel of any elasticity or mobility.

Clinical significance

Injury to the temporal region, even without significant force, easily fractures the bone. The sharp edges of the fracture tear the embedded artery. As the blood in the artery is under high pressure, it begins to rapidly flow into the epidural space, separating the dura mater.

This mass of blood begins compressing the brain from outside. The situation develops so rapidly that without urgent craniotomy, clot removal, and cessation of bleeding, the patient may die within several hours after the injury.