Organization of the Middle Meningeal Artery in a Sample of Black South African Population: Clinical Correlates.

Background: The middle meningeal artery (MMA) is the leading supplier of the cranial dura and serves as a donor blood channel in craniotomy and cerebrovascular bypass procedures. However, the complex embryology of the MMA and population differences give rise to several anatomic variations that are of great importance in head injuries pertaining to the petrous and squamous parts of the temporal bone. Similarly, care must be taken to protect the artery during surgical operations that involve the maxillary artery and the vidian nerve.

Aim: To evaluate the morphometry and clinical correlates of the middle meningeal artery in the black population of South Africa.

Methods: The current study investigated the organization of the MMA in 100 adult dry human skulls (n = 50 males: n = 50 females) by tracing its grooves and measuring the length of the MMA, its frontal branch (FB), parietal branch (PB), the angle between FB and PB, and the angle of MMA from the foramen ovale (FO) bilaterally.

Results: In comparison to females, males had significantly longer left PB (P = 0.003) and a considerably larger right angle of the MMA from the FO (P = 0.018). Furthermore, the PB was significantly longer on the left side than the right side in the entire sample (P = 0.002). Other parameters had no significant differences in sex and side.

Conclusions: The longer PB and the larger angle of the MMA in males could be attributed to why there is a high incidence of chronic subdural hematomas and MMA aneurysms in males. The current study is the first to propose a possible explanation for the aforementioned findings with regard to the organization of the MMA.