Anatomy of the bony canal containing the middle meningeal artery for a vessel-sparing craniotomy in moyamoya disease

The authors aimed to investigate the anatomical features of bony canals containing the middle meningeal artery (MMA) to enhance vessel preservation during craniotomy in patients with moyamoya disease (MMD). They analyzed 175 dry skulls and cranial CT scans, revealing that the incidence of bony canals significantly increases with age and that MMD patients exhibit longer and wider canals compared to those with atherosclerotic cerebrovascular disease. This study underscores the importance of understanding MMA anatomy for surgical procedures involving bypass surgery in MMD.