Which is more likely to be damaged in pterion damage either middle meningeal artery or the vein?

Answer 1

Pterion is the junction of the greater wing of the sphenoid, squamous temporal, frontal, and parietal bones in the lateral wall of the skull. Fracture of the pterion can be life-threatening because it overlies the anterior branches of the middle meningeal vessels, which lie in grooves on the internal aspect of the lateral wall of the calvaria. The pterion is two fingers' breadth superior to the zygomatic arch and a thumb's breadth posterior to the frontal process of the zygomatic bone. A hard blow to the side of the head may fracture the thin bones forming the pterion, producing a rupture of the anterior branch of the middle meningeal artery crossing the pterion. Middle meningeal artery is a branch of the Maxillary artery; branch of the external carotid artery. As blood is pumped against the gravity, pressure inside the external carotid artery is high. Therefore in a fracture arteries can bleed profusely. But the middle meningeal veins are more superficial. According to experienced neurosurgeons veins are easily damaged due to above reason. The resulting hematoma exerts pressure on the underlying cerebral cortex. An untreated middle meningeal artery hemorrhage may cause death in a few hours. Therefore it is wise to mention that it damages to the middle meningeal vessels.