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Trigeminal neuralgia: MR imaging features.

R R Tash1, G Sze, D R Leslie

  • 1Department of Diagnostic Imaging, Yale School of Medicine, New Haven, CT 06510.

Radiology
|September 1, 1989
PubMed
Summary
This summary is machine-generated.

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Magnetic resonance imaging (MRI) can identify vascular compression of the trigeminal nerve (fifth cranial nerve) in patients with trigeminal neuralgia. This neurovascular contact, though sometimes asymptomatic, is crucial for diagnosing the cause of facial pain.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Trigeminal neuralgia (TN) is a debilitating neuropathic pain condition.
  • The exact etiology of TN is often linked to neurovascular compression.
  • Accurate imaging is essential for diagnosis and treatment planning.

Purpose of the Study:

  • To evaluate the relationship between the cisternal portion of the fifth cranial nerve and vascular structures using MR imaging.
  • To compare findings in patients with TN versus asymptomatic individuals.
  • To assess the diagnostic utility of MR imaging in TN.

Main Methods:

  • Magnetic resonance (MR) imaging was employed.
  • Evaluated six patients with documented trigeminal neuralgia.
  • Examined 85 asymptomatic individuals (170 trigeminal nerves).

Related Experiment Videos

  • Focused on the fifth cranial nerve's course from root entry zone (REZ) to Meckel cave and its relation to the vertebrobasilar system.

    • Main Results:

    • MR imaging clearly visualized the fifth nerve and surrounding vasculature.
    • Vascular structures at the REZ were identified in all six TN patients.
    • In asymptomatic subjects, 30% showed vascular contact at the REZ, but only 2% had nerve deformity.
    • Neurovascular contact may be asymptomatic.

    Conclusions:

    • MR imaging is valuable for demonstrating neurovascular contact in TN.
    • The presence of vascular structures at the REZ in TN patients suggests a potential cause.
    • MR imaging should be the initial screening tool for suspected trigeminal neuralgia, surpassing CT limitations.