Imaging of Vascular Compression Syndromes

Trigeminal neuralgia, hemifacial spasm, vestibulocochlear neuralgia and glossopharyngeal neuralgia represent the most common neurovascular compression syndromes. Repeated vascular pulsations at the vulnerable transitional zone of the individual cranial nerves lead to focal axonal injury and demyelination. High-resolution 3-D T2-weighted MR imaging is essential in detecting and mapping neurovascular compression for directed therapy. Knowledge of the specific nerve root exit, the transitional zones, and the adjacent vasculature is critical in proper management. Treatment options for these neurovascular compressions syndromes run the gamut from medical therapy to stereotactic radiosurgery to botulinum injections and to surgical decompression.