A neurosurgical trainee learns that pain from a supratentorial meningioma irritating the dura of the anterior cranial fossa is referred to the forehead. The anterior fossa dura derives its sensory supply chiefly from which nerve?

• A Greater occipital nerve, a branch of C2
• B Anterior ethmoidal nerve, a branch of the ophthalmic division ✓
• C Meningeal branch of the vagus nerve
• D Lesser occipital nerve, a branch of C2 and C3

Explanation

Supratentorial dura is supplied by the trigeminal nerve: the anterior cranial fossa and anterior falx by the anterior and posterior ethmoidal nerves (branches of V1), and the middle fossa dura by meningeal branches of V2 and V3. Infratentorial dura is supplied by upper cervical nerves and the vagus. This explains why supratentorial lesions cause frontal headache while posterior fossa lesions refer pain to the neck and behind the ear.

Reference: Gray's Anatomy, 42nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.