Nerve Atrophy in Severe Trigeminal Neuralgia: Noninvasive Confirmation at MR Imaging—Initial Experience

Abstract

The results indicate that trigeminal nerve atrophy can be depicted noninvasively in patients with trigeminal neuralgia.

Severity Analysis of Neurovascular Contact in Patients with Trigeminal Neuralgia: Assessment with the Inner View of the 3D MR Cisternogram and Angiogram Fusion Imaging

“…[3][4][5][6][7][8][9][10][11][12] Symptomatic NVC is often found at the affected trigeminal nerve, but asymptomatic NVC is also detected at the contralateral and normal trigeminal nerves. 3,4,6 Regarding the MR imaging findings of the NVC, it remains to be clarified whether the NVC by an artery or a vein at the trigeminal nerve root entry zone causes TN.…”

“…Majoie et al 4 studied 13 patients with TN and 50 control subjects without symptoms of TN; severe NVC was detected in 10/13 (77%) at the affected trigeminal nerves and in 8/113 (7%) at the contralateral and normal ones. Additionally, Erbay et al 7 analyzed nerve atrophy in 31 cases of severe TN; the mean diameter and crosssectional area of the affected trigeminal nerves were significantly smaller than the asymptomatic nerves on the contralateral sides. The above results indicate that innocent juxtaposition of the trigeminal nerve and vessels is infrequently found with MR imaging, but a trend toward greater compression severity of the NVC is more frequently found at the affected trigeminal nerve than at the contralateral and normal trigeminal nerves.…”

“…[3][4][5][6][7] We have developed the fusion imaging technique to depict the NVC by 3D image reconstruction 8,9 and have applied it in patients with neurovascular compression syndrome, including those with hemifacial spasms, glossopharyngeal neuralgia, and TN. In the present study, we have newly reconstructed the inner view of fusion MR imaging to assess the fine morphologic change in the affected trigeminal nerve just at the site of the NVC; the anatomic relationship of the NVC is projected along the nerve axis from the rootlet toward the orifice of the Meckel cave.…”

“…1,2 Recent advances in MR imaging have provided us with fine volumetric data regarding the anatomic elements composing the NVC. [3][4][5][6][7][8][9][10][11][12] NVC is often detected on the affected side of TN (affected trigeminal nerve), though it is not infrequently observed in the asymptomatic nerve contralateral to the affected side (contralateral trigeminal nerve), as well as in the normal trigeminal nerve in a control subject without TN (normal trigeminal nerve). 3,4,6 The significance of the MR imaging findings of the NVC has not been established, and it remains unclear whether the NVC is symptomatic and linked to cause TN or asymptomatic and observed incidentally.…”

Imaging of Neurovascular Compression Syndromes: Trigeminal Neuralgia, Hemifacial Spasm, Vestibular Paroxysmia, and Glossopharyngeal Neuralgia

“…29,38-41 Erbay et al 39 found that the nerve diameter and cross-sectional area were 20% and 28% smaller on the symptomatic side compared with the asymptomatic side. Horínek et al 40 found that the volume of the affected nerve was, on average, 28% smaller than that of the unaffected nerve; however, only 7 of the 18 patients with TN were diagnosed with nerve atrophy on the basis of MR imaging volumetry.…”