The middle meningeal artery (') is typically the third branch of the first portion of the

maxillary artery The maxillary artery (eg, internal 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 ...

. After branching off the maxillary artery in the

infratemporal fossa The infratemporal fossa is an irregularly shaped cavity that is a part of the skull. It is situated below and medial to the zygomatic arch. It is not fully enclosed by bone in all directions. It contains superficial muscles, including the lower ...

, it runs through the

foramen spinosum The foramen spinosum is a Foramen, small open hole in the greater wing of the sphenoid bone that gives passage to the middle meningeal artery and vein, and the meningeal branch of the mandibular nerve (sometimes it passes through the Foramen ova ...

to supply the dura mater (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 one of the meningeal branches of the ascending pharyngeal artery (and is typically considered the terminal branch of said artery). It passes through the jugular foramen to enter the posterior cranial fossa. It is ...

. 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. It is also considered to be the weakest part of the skull, which makes it clinically si ...

. 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. When this condition occurs in the spinal canal, it is known as a spinal epidural hematoma. There may be loss of consci ...

. In the dry

cranium The skull, or cranium, is typically a bony enclosure around the brain of a vertebrate. In some fish, and amphibians, the skull is of cartilage. The skull is at the head end of the vertebrate. In the human, the skull comprises two prominent ...

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

brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...

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

auriculotemporal nerve The auriculotemporal nerve is a sensory branch of the mandibular nerve (CN V3) that runs with the superficial temporal artery and vein, and provides sensory innervation to parts of the external ear, scalp, and temporomandibular joint. The nerve a ...

, 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 of ...

of human cadavers and also easily damaged in

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

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 th ...

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 n ...

, and between the two roots of the

to the

of the

sphenoid bone The sphenoid bone is an unpaired bone of the neurocranium. It is situated in the middle of the skull towards the front, in front of the basilar part of occipital bone, basilar part of the occipital bone. The sphenoid bone is one of the seven bon ...

, through which it enters the

; it then runs forward in a groove on the great wing of the

, 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 known as a cranial suture, form the sides and roof of the neurocranium. In humans, each bone is roughly quadrilateral in form, and has two surfaces, four bord ...

, 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, 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 lies over the occipital lobes of the cere ...

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

temporal bone The temporal bone is a paired bone situated at the sides and base of the skull, lateral to the temporal lobe of the cerebral cortex. The temporal bones are overlaid by the sides of the head known as the temples where four of the cranial bone ...

, 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 Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...

and

posterior meningeal arteries The posterior meningeal artery is one of the meningeal branches of the ascending pharyngeal artery (and is typically considered the terminal branch of said artery). It passes through the jugular foramen to enter the posterior cranial fossa. It is ...

. The very smallest distal branches

anastomose An anastomosis (, : 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 (su ...

through the

skull The skull, or cranium, is typically a bony enclosure around the brain of a vertebrate. In some fish, and amphibians, the skull is of cartilage. The skull is at the head end of the vertebrate. In the human, the skull comprises two prominent ...

with small arterioles from the

scalp The scalp is the area of the head where head hair grows. It is made up of skin, layers of connective and fibrous tissues, and the membrane of the skull. Anatomically, the scalp is part of the epicranium, a collection of structures covering th ...

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

trigeminal ganglion The trigeminal ganglion (also known as: Gasserian ganglion, semilunar ganglion, or Gasser's ganglion) is the sensory ganglion of each trigeminal nerve (CN V). The trigeminal ganglion is located within the trigeminal cave (Meckel's cave), a cav ...

and the dura mater # 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 rea ...

, 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 ta ...

, 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 ar ...

of the

posterior auricular artery The posterior auricular artery is a small artery that arises from the external carotid artery. It ascends along the side of the head. It supplies several muscles of the neck and several structures of the head. Structure Origin The artery ar ...

. # A

superior tympanic artery The superior tympanic artery is a small artery in the head. It is a branch of the middle meningeal artery. On entering the cranium it runs in the canal for the tensor tympani muscle The tensor tympani is a muscle within the middle ear, located in ...

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 thun ...

muscle, and supplies this muscle and the lining of the canal. # Orbital branches pass through the

superior orbital fissure The superior orbital fissure is a foramen or cleft of the skull between the lesser and greater wings of the sphenoid bone. It gives passage to multiple structures, including the oculomotor nerve, trochlear nerve, ophthalmic nerve, abducens nerve ...

or through separate canals in the great wing of the sphenoid, 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 ...

. # Temporal branches pass through foramina in the great wing of the sphenoid, 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 above, and the zygomatic arch below. Its floor is formed by the outer surfaces of four bones of the skull. The fossa is filled by the te ...

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 de ...

Variation

In approximately half of subjects, it branches into an

accessory meningeal artery Accessory may refer to: * Accessory (legal term), a person who assists a criminal In anatomy * Accessory bone * Accessory breast * Accessory kidney * Accessory muscle * Accessory nucleus, in anatomy, a cranial nerve nucleus * Accessory nerve * ...

. 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 (anatomy), 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 sup ...

Clinical relevance

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

. A head injury (e.g., from a

road traffic accident A traffic collision, also known as a motor vehicle collision, or car crash, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other moving or stationary obstruction, such as a tree, pole or building. Tr ...

sports injury Sports injuries occur during participation in sports or exercise in general. Globally, around 40% of individuals engage in some form of regular exercise or organized sports, with upwards of 60% of US high school students participating in one or ...

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

craniotomy A craniotomy is a surgery, surgical operation in which a bone flap is temporarily removed from the Human skull, skull to access the Human brain, brain. Craniotomies are often critical operations, performed on patients who are suffering from brain ...

Subdural bleeding A subdural hematoma (SDH) is a type of bleeding in which a collection of blood—usually but not always associated with a traumatic brain injury—gathers between the inner layer of the dura mater and the arachnoid mater of the meninges surroun ...

is usually ''venous'' in nature, rather than arterial. Nevertheless, embolization of the middle meningeal artery (as a supplementary treatment to craniotomy) significantly reduces the likelihood of recurrence and reoperation for subdural hematomas, as the artery supplies blood to the vascularized membrane around the hematoma that leaks blood and prevents its resorption. 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 (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

, 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.

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