Assessing the risk of middle meningeal artery damage in pterional craniotomy: An anatomical appraisal using an adult dry skull population

Glasson, M., Temple, K., Gilder, M., Inskip, S., Williams, E., Sofaer, J. and Border, S. (2011) Assessing the risk of middle meningeal artery damage in pterional craniotomy: An anatomical appraisal using an adult dry skull population. Joint winter meeting of the Anatomical Society, British Association of Clinical Anatomists, and the Institute of Anatomical Sciences, University of Cardiff, Cardiff, United Kingdom. 19 - 21 Dec 2011. p. 802 .

Abstract

The location of the pterion in relation to the middle meningeal artery (MMA) is of interest for pterional craniotomy. The aim of this study was to determine the anatomical relationship between the pterion and the MMA in 94 dry adult skulls. Transillumination was used to visualize the anterior MMA grooves and the frequency with which they entered specific bony territories. Pterion morphology was found to be 82% sphenoparietal, 14% epipteric, and 4% frontotemporal. A sex difference between type and occurrence of pterion was found (P < 0.01). The sphenoid ridge was found to be significantly closer to the pterion center point bilaterally in females (right P < 0.022: left P < 0.026). Eighty percent of the vessel grooves were involved with the pterion. There was a high incidence of a sphenoid to parietal direction across the pterion region when compared with other configurations (P < 0.001). The MMA was located behind the sphenoid, parietal, and temporal bones but rarely behind the frontal bone. We found the MMA travelling posterior to the entire pterion in one-fifth of cases. These findings suggest that the anterior branch of the MMA is not always associated with the pterion and has highlighted specific areas of vascular risk for pterional craniotomy.

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Contributors

Author: J. Sofaer

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