An extradural haematoma classically follows rupture of the middle meningeal artery. At which point is this artery most vulnerable to fracture of the pterion?
- A At the foramen ovale
- B As it exits the foramen spinosum and grooves the inner table of the squamous temporal bone anterior to the external acoustic meatus ✓
- C In the cavernous sinus
- D At the posterior division near the mastoid process
Explanation
The middle meningeal artery enters the skull through the foramen spinosum and immediately enters a groove (sulcus) on the inner surface of the squamous temporal bone, running anterosuperiorly toward the pterion. The pterion is the thinnest part of the skull (where the frontal, parietal, temporal, and greater wing of sphenoid converge), and a fracture here can tear the anterior division of the middle meningeal artery. The artery may even run within a bony canal in the temporal bone in some individuals, further increasing haemorrhage risk. The classic presentation is a lucid interval followed by rapid neurological deterioration.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.