The Role of Imaging for Trigeminal Neuralgia: A Segmental Approach to High-Resolution MRI

High-resolution MRI affords exquisite anatomic detail and allows radiologists to scrutinize the entire course of the trigeminal nerve (cranial nerve [CN] V). This article focuses first on the normal MRI appearance of the course of CN V and how best to image each segment. Special attention is then devoted to the role of MRI in presurgical evaluation of patients with neurovascular conflict and in identifying secondary causes of trigeminal neuralgia, including multiple sclerosis. Fundamental concepts in postsurgical imaging after neurovascular decompression are also addressed. Finally, how imaging has been used to better understand the etiology of trigeminal neuralgia is discussed.