Guidelines for Radiographic Imaging of Cranial Neuropathies

Abstract

Disruption of the complex pathways of the 12 cranial nerves can occur at any site along their course, and many, varied pathologic processes may initially manifest as dysfunction and neuropathy. Radiographic imaging (computed topography or magnetic resonance imaging) is frequently used to evaluate cranial neuropathies; however, indications for imaging and imaging method of choice vary considerably between the cranial nerves. The purpose of this review is to provide an analysis of the diagnostic yield and the most clinically appropriate means to evaluate cranial neuropathies using radiographic imaging. Using the PubMed MEDLINE NCBI database, a total of 49,079 articles' results were retrieved on September 20, 2014. Scholarly articles that discuss the etiology, incidence, and use of imaging in the context of evaluation and diagnostic yield of the 12 cranial nerves were evaluated for the purposes of this review. We combined primary research, guidelines, and best practice recommendations to create a practical framework for the radiographic evaluation of cranial neuropathies.

The Symptoms and Clinical Manifestations Observed in COVID-19 Patients/Long COVID-19 Symptoms that Parallel Toxoplasma gondii Infections

“…Several distinctive Long COVID-19 symptoms can be matched if toxoplasmosis induced cranial nerve palsies affect the functions of the 12 cranial nerves, creating symptoms including anosmia from a palsy of the olfactory nerve (I), vertigo (dizziness), tinnitus and otalgia (earache) from a palsy of the vestibulocochlear nerve (VIII), and dysgeusia from palsies of the facial nerve (VII), glossopharyngeal nerve (IX), and vagus nerve (X) (Khaku et al 2017 ).…”

Polymorphous low-grade adenocarcinoma with cavernous sinus involvement presenting as third nerve palsy

“…20 Current guidelines suggest that close observation is appropriate in patients who are older than 50 years of age, have known risk factors for third nerve palsy, and present with no pupillary abnormalities. 21 , 22 However, pupillary abnormalities are not uncommon after eye surgeries and limit reliable assessment of pupillary involvement. 23 Further, pupillary constriction and dilation are less dynamic in patients with known diabetic neuropathy.…”

Improved Lesion Conspicuity with Contrast-Enhanced 3D T1 TSE Black-Blood Imaging in Cranial Neuritis: A Comparative Study of Contrast-Enhanced 3D T1 TSE, 3D T1 Fast-Spoiled Gradient Echo, and 3D T2 FLAIR

“…ABBREVIATIONS: FSPGR ¼ fast-spoiled gradient echo; CE ¼ contrast-enhanced; GRE ¼ gradient-echo; CNR ¼ contrast to noise ratio; ROC ¼ receiver operating characteristic; AUC ¼ area under the ROC curve; TSE ¼ turbo spin-echo C ranial neuropathies can have multiple causes, including infectious, neoplastic, inflammatory, traumatic, and idiopathic pathologies. 1 Such conditions cause disruption of the blood-nerve barrier, which is sustained by the combined actions of tight junctions in the endothelium of the endoneurial capillaries and of the inner layers of the perineurium. 2 Contrast-enhanced (CE) MR imaging plays an important role in the diagnosis of cranial neuritis by visualizing nerve enhancement attributed to leakage forcing spillage and accumulation of contrast material surrounded by CSF.…”