Branch Of Middle Meningeal Artery Research Articles

Different ophthalmic artery origins: Embryology and clinical significance

This retrospective study gives a summary of ophthalmic artery (OA) variations to serve as guidelines for surgical interventionists and trainees. Pubmed and Medline searches were conducted. The OA usually arises intradurally (superomedial, anteromedial, or rarely superolateral) from the internal carotid artery (ICA). Rare extradural origin (primitive dorsal OA) (PDOA) remnant and extremely rare interdural origin (primitive ventral OA) (PVOA) remnant are of significance when sectioning the dural ring. Rarely, a persistent PDOA with ICA origin, or a PDOA remnant with inferolateral trunk origin, enters the orbit via the superior orbital fissure (SOF) for sole or partial orbital supply. Extremely rare, the PDOA and PVOA persist and form double OAs that arise from the ICA and run via the SOF and optic foramen. Occasionally, the OA arises from the middle meningeal artery (MMA), when both the PDOA and VDOA regress and enter the orbit via the SOF. Sole orbital supply via the external carotid artery (ECA), i.e. meningo-ophthalmic artery and/or MMA branches, or dual OAs (ECA and ICA origins) may occur. Other rare OA origins include anterior or posterior communicating artery; anterior or middle cerebral artery; basilar artery; posterior inferior cerebellar artery; and the carotid bifurcation. Primitive arteries (persistent or remnant), and/or abnormal anastomoses play pivotal roles in manifestations of OA variations. Of clinical importance are orbital collateral routes and dangerous extracranial-intracranial anastomoses. Awareness of OA origins and collateral routes is imperative for transarterial embolizations or infusion chemotherapy in the ECA territory to prevent visual complications.

Unique variation in the course of maxillary artery in infratemporal fossa: a case report

Maxillary artery is one of the key contents of the infratemporal fossa. Mandibular nerve and its branches form a clinically important relation of maxillary artery in this region. A comprehensive knowledge of variations of maxillary artery in the fossa is of special relevance in oral maxillofacial surgeries, management of epistaxis, intractable neuralgias or headaches. We found a unique variation of maxillary artery, presenting bilaterally, in relation to branches of mandibular nerve. During routine dissection in a 55-year-old male cadaver, maxillary artery was seen passing deep to lateral pterygoid muscle and crossed through the nerve loop formed between two roots of auriculotemporal nerve and posterior division of mandibular nerve. Further course of maxillary artery was medial to the posterior division of mandibular nerve. Maxillary artery gave its middle meningeal artery branch as it traversed through the nerve loop. A tortuous course taken by maxillary artery can lead to its entrapment causing headaches or nerve irritation presenting with neuralgia.

Meningeal management for optimal revascularization from middle meningeal artery

Numerous surgical techniques have been developed and refined for the treatment of moyamoya disease. Among the indirect techniques of revascularization, encephaloduroarteriosynangiosis has been recognized as effective in promoting revascularization and reversing symptomatology. Neovascularization occurs between the donor artery, either the superficial temporal artery or the occipital artery, and the underlying ischemic cortex. Additionally, the middle meningeal artery and its dural branches have also been shown to contribute to collateral blood supply. In this report the authors describe an integrated management of the meninges for optimal revascularization. They emphasize the importance of recognizing the 3 major layers of the dura and describe a technique of dural splitting at the locus minoris resistentiae between the dura mater's vascular (middle) layer and internal median layer. Applying the dura's vascular layer to the surface of the brain after opening of the arachnoid is designed to optimize dural-pial synangiosis related to middle meningeal artery branches.

Bony Canals Along The Course of Middle Meningeal Artery In Dry Skulls

Abstract Background : The middle meningeal artery courses in the middle cranial fossa and divides into two or three branches. The branches of the artery are sometimes enclosed within a bony canal. The artery and its branches are likely to get tom in cases of epidural hematomas and may require ligation. Aims: The aim of the study is to report the variations in the branching pattern of middle meningeal artery and incidence of bony canals along the course of these branches. Materials: The study material consisted of 77 bases of dry skulls (154 sides) and the findings were supplemented with dissection of four cadaveric skulls. Results and Conclusions : The length of stem of middle meningeal artery, from foramen spinosum to its division into branches varied from 0.56 to 5.83 mm on the right side and 0.58- 7.53mm on the left. The mean length of the stem was 3.04 on the right side and 3.01 on the left (S D ± 1.4). The middle meningeal artery divided into anterior and posterior branches in all the sides of skull. A middle branch constituting a third branch of middle meningeal artery was observed in 44.15% (68 sides) which arose either from its anterior 35.29% (24 sides) or posterior branch 64.71 % (44 sides). Bony canals were observed in 39.61 % (61 sides). The anterior branch was enclosed in a bony canal in 37.66% (58 sides) and the posterior branch in 1.94% (3 sides). The variations in the course, branching pattern and bony canals along middle meningeal artery are of clinical significance while treating extradural and subdural hemorrhages as due to these variations and presence of bony canal in course of middle meningeal artery, ligation of the vessel may be totally or partially insufficient.

Bony canals along the course of middle meningeal artery in dry skulls

Background: The middle meningeal artery courses in the middle cranial fossa and divides into two or three branches. The branches of the artery are sometimes enclosed within a bony canal. The artery and its branches are likely to get torn in cases of epidural hematomas and may require ligation. Aims: The aim of the study is to report the variations in the branching pattern of middle meningeal artery and incidence of bony canals along the course of these branches. Materials: The study material consisted of 77 bases of dry skulls (154 sides) and the findings were supplemented with dissection of four cadaveric skulls. Results and Conclusions: The length of stem of middle meningeal artery, from foramen spinosum to its division into branches varied from 0.56 to 5.83 mm on the right side and 0.58- 7.53mm on the left. The mean length of the stem was 3.04 on the right side and 3.01 on the left (S D ± 1.4). The middle meningeal artery divided into anterior and posterior branches in all the sides of skull. A middle branch constituting a third branch of middle meningeal artery was observed in 44.15% (68 sides) which arose either from its anterior 35.29% (24 sides) or posterior branch 64.71% (44 sides). Bony canals were observed in 39.61% (61 sides). The anterior branch was enclosed in a bony canal in 37.66% (58 sides) and the posterior branch in 1.94% (3 sides). The variations in the course, branching pattern and bony canals along middle meningeal artery are of clinical significance while treating extradural and subdural hemorrhages as due to these variations and presence of bony canal in course of middle meningeal artery, ligation of the vessel may be totally or partially insufficient.

Pterion: An anatomical variation and surgical landmark

Introduction : The frontal and the parietal bones superiorly and the greater wing of the sphenoid and the squamous temporal inferiorly of one side meet at an H-shaped sutural junction termed the pterion. This is an important anatomical and anthropological landmark as it overlies both the anterior branch of middle meningeal artery and the lateral fissure of the cerebral hemisphere. The knowledge of sutural joints between frontal, parietal, sphenoid and temporal bones at pterion is clinically, radiologically and surgically important during surgical interventions involving burr hole surgeries. Materials and Methods : Study performed on 150 dry temporal bones. The pterion, and its sutural articulations with frontal, parietal, sphenoid and temporal bones and also anatomical variations, if any, were studied. Results : Four types of pterion, i.e. sphenoparietal, frontotemporal, stellate and epipteric, were observed. Conclusions : The knowledge of the variations of pterion and its surgical anatomy, in Indian population are important for surgeons operating in the fieldThe present study will also contribute additional information of skull bone fractures in infancy and early childhood, which may be associated with large intersutural bones giving false appearance of fracture radiologically and also during surgical interventions involving burr hole surgeries, as their extensions may lead to continuation of fracture lines.

Use of frameless stereotactic computed tomography venography for intraoperative localization of dural arterial venous fistulas: case report

Background The following technical case report illustrates the use of multiple imaging modalities including 3D CTV with frameless stereotactic navigation for intraoperative planning and localization for surgical obliteration of a cranial dAVF with leptomeningeal drainage. Case Description This 65-year-old man presented with an asymptomatic occipital dAVF with leptomeningeal drainage. In addition to cerebral angiography, a CTV with 3D reconstruction was performed, which provided excellent visualization of the dAVF and clarified its pattern of drainage. The dAVF was supplied by a middle meningeal artery branch that drained into an occipital cortical vein, which then retrograde filled the vein of Labbé. Frameless stereotactic navigation with the imported CTV images was used to plan the craniotomy and to localize the leptomeningeal draining vein and vein of Labbé. The draining vein of the fistula was successfully ligated and divided while preserving flow in the vein of Labbé. Postoperative angiogram demonstrated complete obliteration of the dAVF. Conclusion Integration of a 3D reconstructed CTV with conventional angiographic information optimized our surgical understanding of the spatial anatomy of this dAVF and its pattern of venous drainage. Applying the CTV with frameless stereotaxy allowed for safe obliteration of the dAVF while preserving the vein of Labbé.

Neurogenic vasodilation of dural blood vessels is not mediated by cholinergic transmission in the anaesthetised rat

Dural vessel dilation induced by activation of trigeminal sensory fibres may be responsible for some component of the migraine attack. The presence in some patients with migraine and cluster headache of clinical features, such as lacrimation, suggests cranial parasympathetic activation and poses the question as to whether neurogenic meningeal dilatation has a cholinergic component. Rats were prepared in order to record on-line the diameter of a middle meningeal artery branch through a closed cranial window using an intravital microscope coupled to a video dimension analyser. Acetylcholine (1 μg, intravenously, i.v.) was administered before and after muscarinic receptor inhibition ( n=5) with scopolamine (2 mg/kg, i.v.) or nicotinic receptor inhibition ( n=6) with mecamylamine (4 mg/kg, i.v.). Further vasodilation was induced by electrical stimulation of the cranial window surface before and after muscarinic receptor inhibition with i.v. scopolamine ( n=8). The mean dural vessel percentage increase caused by acetylcholine stimulation was significantly different before and after muscarinic receptor inhibition ( P=0.045). Moreover, there was no difference between the post receptor inhibition values and those obtained after vehicle infusion ( P=0.431). In contrast, no difference was detected in the effect of acetylcholine before and after nicotinic receptor inhibition ( P=0.688). In the second experiment, where the effect of muscarinic receptor inhibition on the neurogenic dilation model was assessed, no significant difference was demonstrated ( P=0.538). Cholinergic dilation of the rat dural arteries is mediated by muscarinic receptors, but this mechanism does not play a significant role in the rat dural vessel dilation induced by closed cranial window electrical stimulation.

Mixed desmoplastic primitive neuroepithelial tumor of infancy: a light microscopic, immunocytochemical, ultrastructural and genetic study

We describe a case of a desmoplastic brain tumor which was initially resected from the right fronto-temporal region in a 2 year-old boy. This nodular, calcified tumor was vascularized by the internal carotid artery and the middle meningeal artery branches. Grossly, it contained several mucoid cysts. Light microscopy showed cords or nests of small cuboidal cells surrounded by a loose connective tissue and desmoplastic areas containing fibers and spindle cells. The cuboidal cells expressed epithelial, neuronal and neuroendocrine markers. Some foci of spindle cells showed glial differentiation. The tumor recurred 16 months later and displayed some characteristics of the small cell neuroepithelial component, mitoses being conspicuous. Electron microscopy revealed undifferentiated clear cells, some containing neurosecretory granules. Karyotyping demonstrated the following formula: < 15 > 46, t(8;11) (q13; q11). The chromosome 11 breakpoint was different from that described in Ewing's sarcoma. This isolated translocation has not been previously reported to our knowledge. These unusual features lead us to report this case and to discuss its pathogenesis.

Variations of the middle meningeal artery: Significance for surgery and practice

AbstractThe origin and branching of the middle meningeal artery (MMA), as well as the length and development of its three main branches, were analyzed by following the arterial sulci on skull bones. We examined 186 macerated skulls (128 male and 58 female). Variations were classified into nine types. Some of the previously ignored communications of the branches of MMA with other arteries of the external carotid systems such as the deep temporal a., deep auricular a., occipital a., and anterior tympanic a. are described. © 1993 Wiley‐Liss, Inc.