A 25-year-old man, a football player, presents to the emergency department after having lost consciousness during a game. He is very drowsy, with a Glasgow Coma Score of 13. A CT scan shows an extradural haemorrhage.
Which blood vessel is the patient bleeding from?
A Internal carotid artery
B Middle cerebral artery
C Middle meningeal artery
D Superficial temporal artery
E Superior sagittal sinus
Answer And Explanation: C Middle meningeal artery
The middle meningeal artery is a branch of the maxillary artery which along with the superficial temporal artery is one of the terminal branches of the external carotid artery. It enters the middle cranial fossa through the foramen spinosum and divides into an anterior and posterior branch. It is the cause of bleeding in extradural haemorrhage because it lies deep to the squamous part of the temporal bone which is a very thin part of the cranium, and therefore easily fractured. A burr hole is usually made at the level of the pterion to access the middle meningeal artery to stop the bleeding, although the ideal surgical procedure is a craniotomy.
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