American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which artery is commonly involved in the formation of an epidural hematoma?

1. Anterior cerebral artery

2. Middle meningeal artery

3. Posterior cerebral artery

4. Vertebral artery

The correct answer is: Middle meningeal artery

The middle meningeal artery is commonly involved in the formation of an epidural hematoma. This artery, which branches from the maxillary artery, courses between the inner layer of the skull and the dura mater. When there is a skull fracture, especially in the temporal region, it can lead to tearing of this artery. The resulting bleeding from the middle meningeal artery occurs in the potential space between the dura mater and the skull, leading to the accumulation of blood that forms an epidural hematoma. This condition is characterized by a rapid increase in intracranial pressure and can present with a classic lucid interval followed by rapid deterioration. In contrast, other arteries listed, such as the anterior cerebral artery and the posterior cerebral artery, are involved in different types of hemorrhages, primarily subdural hematomas or intracerebral hematomas, rather than epidural hematomas. The vertebral artery is primarily related to posterior circulation strokes rather than the scenario associated with an epidural hematoma. Thus, the involvement of the middle meningeal artery is a classic identifier of epidural hematomas in clinical practice.