The posterior meningeal artery (PMA) is the largest artery supplying the dura mater of the posterior cranial fossa ref.
Gross anatomy
Origin and course
The origin of the posterior meningeal artery is quite variable 1,2. It most commonly arises from the V3 segment and occasionally from the V4 segment of the vertebral artery 1. But rarely it can also arise from the occipital artery, the ascending pharyngeal artery, the upper cervical part of the internal carotid artery or the posterior inferior cerebellar artery 2.
It can be divided into two segments: a tortuous extracranial segment and a relatively straight intracranial segment.
Extracranial
Like the vertebral artery, it loops lateral to the posterior arch of the atlas and then pierces through the posterolateral intracranial dura.
Intracranial
It enters the posterior cranial fossa via the foramen magnum. It then ascends parallel to the internal occipital crest and falx cerebelli and then over the confluence of sinuses.
Termination
Terminates just above the tentorium cerebelli/confluence of sinuses at the falx cerebri.
Supply
Primarily the intracranial dura of the posterior cranial fossa and anastomoses with the middle meningeal artery and branches of the occipital artery.
Related pathology
Given its close relation with many vessels in the posterior cranial fossa, the PMA can be associated with dural arteriovenous fistulas involving the tentorium cerebelli, the confluence of sinuses or the transverse-sigmoid sinuses ref.