[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Middle meningeal artery [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Middle meningeal artery The middle meningeal artery runs on the inside of the skull at the temple; a skull fracture there can tear it and cause an epidural haematoma. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=middle_meningeal_artery&side=r) Opens in the Durgical app, no sign-up needed. ## What it is An artery under the pterion, inside the skull; a fracture there can tear it and cause an epidural haematoma. ## What it does Feeds the dura and skull; a skull fracture can tear it, causing an epidural haematoma. ## Key points - Epidural haematoma: a blow to the temple tears the frontal branch; a lucid interval may be followed by drowsiness, a dilated pupil on the same side and weakness of the other side - On CT the haematoma is [lens](https://durgical.com/en/anatomy/lens/) -shaped (biconvex) and stops at the sutures, where the dura is firmly attached to the bone - The auriculotemporal nerve splits around the artery just below the foramen spinosum ## Key facts **Origin** Maxillary artery; enters through the foramen spinosum **Branches** Frontal and parietal branches **Supplies** Dura and skull; frontal branch under the pterion (epidural haematoma) ## Relations **Course** From the first part of the [maxillary artery](https://durgical.com/en/anatomy/maxillary-artery/) in the infratemporal fossa it rises deep to the [lateral pterygoid](https://durgical.com/en/anatomy/superior-head-of-lateral-pterygoid-muscle/), through the loop of the auriculotemporal nerve, enters the middle cranial fossa through the [foramen spinosum](https://durgical.com/en/anatomy/foramen-spinosum/) and runs out across its floor; the frontal branch climbs to the [pterion](https://durgical.com/en/anatomy/pterion/) and the parietal branch runs backward **Superficial** Inner table of the skull, which it grooves; at the pterion, where the frontal, parietal, temporal and sphenoid bones meet, the bone is thin **Deep** [Dura mater](https://durgical.com/en/anatomy/cranial-dura/), in whose outer layer it runs, and beneath it the temporal and frontal lobes ## How to find it The pterion, over the frontal branch, lies about two finger-breadths above the zygomatic arch and a thumb's breadth behind the frontal process of the [zygomatic bone](https://durgical.com/en/anatomy/zygomatic-bone/). ## On imaging Non-contrast CT: a bright biconvex collection under the temple, often with a fracture crossing the vessel groove on bone windows; darker swirls inside it suggest active bleeding. On plain skull films the vascular grooves can look like a fracture. ## Common problems - Epidural haematoma: bleeding between skull and dura, usually from the middle meningeal artery after a blow; the person may seem fine at first, then worsens. - Subdural haematoma: bleeding under the dura from torn veins, common in older adults and people on blood thinners. ## How it is diagnosed Emergency CT of the head. ## Treatment - Observation for small bleeds. - Urgent craniotomy or burr holes to remove the blood. ## Clinical notes - Arterial bleeding grows fast: the clot can push the medial [temporal lobe](https://durgical.com/en/anatomy/middle-temporal-gyrus/) through the tentorial notch (uncal herniation), compressing the [oculomotor nerve](https://durgical.com/en/anatomy/oculomotor-nerve/) and the brainstem - A large epidural haematoma is an emergency treated by surgical evacuation through a craniotomy - Embolisation of the middle meningeal artery is used to lower the recurrence of chronic subdural haematoma, whose membranes it supplies - When cut it bleeds from both ends, because its branches anastomose with the other meningeal arteries and with the opposite side; at the pterion its frontal branch may run in a bony tunnel, so a fracture there tears it easily ## Anatomical variants - Rarely the [ophthalmic artery](https://durgical.com/en/anatomy/ophthalmic-artery/) arises from it, or the two share a large orbital link; this matters before embolisation - An accessory meningeal artery may arise from it or from the maxillary artery ## Development It is a remnant of the embryonic stapedial artery, whose trunk passes between the two roots of the auriculotemporal nerve; its small orbital twigs are what is left of the stapedial branch to the orbit, explaining links with the ophthalmic artery. ## Memory aid Epidural = lens, stopped by the sutures; subdural = crescent, crossing the sutures. ## Related conditions - [Traumatic brain injury](https://durgical.com/en/conditions/traumatic-brain-injury/) - [Epidural haematoma](https://durgical.com/en/conditions/epidural-haematoma/) ## Test yourself Think of the answer, then tap the question to see it. ## From which artery does the middle meningeal artery arise, and through which foramen does it enter the skull? The first part of the maxillary artery; it enters the middle cranial fossa through the foramen spinosum. ## What is the classic course of an epidural haematoma from a torn middle meningeal artery? A blow to the temple tears the frontal branch under the pterion; a lucid interval, then drowsiness, a dilated pupil on that side and weakness of the other side. ## What does an epidural haematoma look like on CT, and why? Lens-shaped (biconvex) and stopped by the sutures, where the dura is firmly attached to the bone. ## Why is the middle meningeal artery embolised in chronic subdural haematoma? It supplies the haematoma's membranes; embolisation lowers the recurrence. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/middle-meningeal-artery/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** arteria meningea media TA2 4431 **Official Spanish (DeCS)** Arteria meníngea media DeCS D008576 **English (TA2)** Middle meningeal artery **Also called** arteria meningica media ## Related - [Pterion](https://durgical.com/en/anatomy/pterion/) - [Foramen spinosum](https://durgical.com/en/anatomy/foramen-spinosum/) - [Dura mater](https://durgical.com/en/anatomy/cranial-dura/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=8747&filter=ths_termall&q=Meningeal%20Arteries); [Neuroanatomy, Middle Meningeal Arteries](https://www.ncbi.nlm.nih.gov/books/NBK519545/); Anatomy of the Human Body (20th ed.): Development of the Vascular System (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain; Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV, sección 2 Arterias, caps. I-III (sistema de la arteria pulmonar; aorta y ramas del cayado hasta la carótida interna). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/middle-meningeal-artery/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/middle-meningeal-artery/