The So-Called Anterior Meningeal Artery: An Anatomic Study for Treatment Modalities

Abstract

<jats:p> The so called anterior meningeal artery (AMA) is a branch of the vertebral artery (VA), which had been interpreted as a supplying vessel of the dura in the foramen magnum and upper cervical level. </jats:p><jats:p> In this study, we examined the anatomy of this artery and relationships to its surrounding structures for treatment modalities. With the aid of magnification, five adult cadaveric head and neck complex and five cervical spines were examined after perfusion of the vessels with colored silicone. </jats:p><jats:p> The AMA arose from the VA between the C2 and C3 level, and passed medially through the intrervertebral foramen anterior to the dural sheath of the third cervical nerve root. It ran upwards dorsal to the deep layer of the posterior longitudinal ligament (PLL) with anterior internal vertebral venous plexus. Rostrally, it formed an arcade above the apex of the odontoid process with its contralateral mate. </jats:p><jats:p> The AMA gave off several tiny branches to the deep layer of the PLL, ligaments and soft tissues above the apex of the odontoid process, and vertebral bodies of the axis. At the level of the foramen magnum, it ended in several small twigs to the dura. Anastomoses between the AMA system and adjacent vessels were observed. One was directed through the hypoglossal canal to the ascending pharyngeal artery and the other was with the V3 segment of the VA. The origin and course of the two AMA, and anastomoses were symmetric. Although the AMA feeds the ventral dura of the foramen magnum, the perfusion area is larger than its name suggests, including the bony and ligamentous structures in the craniovertebral junction. </jats:p><jats:p> Anatomical knowledge of the AMA, including its anastomoses and layer relationships to the surrounding structures, may help to perform treatment modalities in this region rationally. </jats:p>

Dural arteriovenous fistula of the lateral foramen magnum region: A review

“…Four important arteries of the external carotid artery (ECA) and VA are involved in DAVFs of the lateral FM region. These include the hypoglossal and jugular branches of the ascending pharyngeal artery (APhA), [31][32][33][34] the anterior meningeal artery (AMA) of the VA, 32,35,36 the posterior meningeal artery (PMA) 32,37 and the mastoid and hypoglossal branches of the occipital artery (OA). 32,38 In these arteries, wide anastomoses often occur through the odontoid arch and via the cavernous internal carotid artery (ICA) through the meningeal branch.…”

Recanalization of a large supraclinoid carotid aneurysm via elicited vertebral artery-internal carotid artery anastomosis: case report

“…The AMA is a branch of the VA, which supplies the dura in the foramen magnum and the upper cervical region (7). The AMA arises from the VA between the C2 and C3 levels, and forms an arcade above the apex of the odontoid process with its contralateral mate (7,9). It anastomoses with the hypoglossal branch from the APA, which passes through the hypoglossal canal (3,7,9).…”

“…The AMA arises from the VA between the C2 and C3 levels, and forms an arcade above the apex of the odontoid process with its contralateral mate (7,9). It anastomoses with the hypoglossal branch from the APA, which passes through the hypoglossal canal (3,7,9). This anastomosis (pharyngovertebral anastomosis) is well known, because it may cause palsy of the lower cranial nerves in intravascular embolization for lesions fed by the AMA (9).…”