Question 280

Question:

A 22-year-old intoxicated male presents with a painful headache following a bar fight. Head CT reveals a biconvex mass adjacent to a fractured right temporal bone. The artery implicated in the injury passes through the cranium through the same foramen as which of the following nerves?

Correct Answer: B.  Meningeal branch of the mandibular nerve

A biconvex (lens-shaped) mass is strongly indicative of an epidural hematoma, which most commonly results from injury to the middle meningeal artery secondary to temporal bone fracture. The middle meningeal artery enters the cranium through the foramen spinosum together with the meningeal branch of the mandibular nerve (B), which is also called nervus spinosum.

The maxillary nerve (A), the V2 division of the trigeminal nerve, courses through the foramen rotundum, not the foramen spinosum.

The meningeal branch of the maxillary nerve (C), also called the middle meningeal nerve (D), does not pass through a foramen in the skull. It branches directly off of V2 immediately after its origin from the trigeminal ganglion.

The nervus intermedius (E) enters the internal auditory canal, not the foramen spinosum. Nervus intermedius should not be confused with nervus spinosum, which is another name for the meningeal branch of the mandibular nerve.