Variant anatomy of intracranial part of middle meningeal artery in a Kenyan population

Abstract

Anatomy of the intracranial part of middle meningeal artery is important during ligation or embolization in epidural haematomas, and in surgical approach to the middle cranial fossa. It shows population variations, but reports from African populations are scanty. This study aimed at describing the variant anatomy of intracranial part of middle meningeal artery in a black Kenyan population. One hundred and sixty middle meningeal arteries and grooves from 80 cadaveric cranial cavities of adult black Kenyans obtained from the Department of Human Anatomy, University of Nairobi Kenya were studied. Measurements taken included length of main trunk, horizontal distance from the branching point to a perpendicular line through midpoint of the zygomatic arch, and a horizontal line from the branching point to a perpendicular line through the tip of the tragus. The branching point of all intracranial divisions was anterior to the tragus and in majority of cases (84.9%) posterior to the mid-zygomatic line. The mean distance from the tip of tragus to the point of intracranial division was 30.6 mm, with 57.9% of the cases lying between 20 mm and 35 mm. The average vertical height of the artery from zygomatic point was 10.6 mm, with about two thirds (64.1%) between 3 mm and 22 mm. Majority (51.3%) of the intracranial trunks were between 5 mm and 13 mm long. There were 95.6% and 4.4% bifurcations and trifurcations respectively. The anterior division was deep to the pterion in 66.3%, posterior in 27.5% and anterior in 6.3% of cases. This study revealed that the termination point of the middle meningeal artery in the Kenyan population lies about 14 mm posterior to the mid zygomatic line and about 31 mm from a perpendicular line through the tip of the tragus. It displays variations in stem length, pattern of branching. Only two – thirds of anterior divisions lie deep to the pterion. Neurosurgeons should be aware of these variations during ligation or embolization of the artery and in enlarged middle cranial fossa approach