[Cerebral nerves - perineural tumor spread]

Perineural tumor spread in the course of head and neck tumors is a form of metastatic disease in which the tumor disseminates centrifugally or centripetally along the nerve to (non)contiguous regions. Perineural tumor spread is a potentially devastating complication and has a high impact on the therapeutic management and overall prognosis. In a large proportion of patients the disease remains asymptomatic and imaging (especially MRI) plays a crucial role in the detection of lesions. Familiarity with the pertinent anatomy, knowledge of the common spread pathways and an appropriate imaging strategy allow detection of the perineural spread of the disease in the majority of the cases.