Uncommon Cause of Trigeminal Neuralgia: Tentorial Ossification over Trigeminal Notch

Abstract

Ossification of the tentorium cerebelli over the trigeminal notch is rare, but it may cause compression of the trigeminal nerve, leading to trigeminal neuralgia (TN). We were unable to find any previously reported cases with radiological evaluation, although we did find one case with surgically proven ossification of the tentorium cerebelli. Here, we present a case of TN caused by tentorial ossification over the trigeminal notch depicted on magnetic resonance imaging (MRI) and computed tomography (CT).

Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

“…13,17,25 It was hypothesized that the posterior petroclinoid dural fold may completely ossify in adults, leading to a narrowing of the trigeminal porus and compression of the trigeminal nerve. 8,11,18,26 Hence knowledge of the anatomical characteristics of both the dural entrance to Meckel's cave and the dural sheath of the trigeminal nerve are important from a clinical point of view. 18,[26][27][28] Ossification of the tentorium cerebelli over the trigeminal notch (ossification of the pPCL) should be taken into account during surgical decompression of the trigeminal nerve.…”

“…8,11,18,26 Hence knowledge of the anatomical characteristics of both the dural entrance to Meckel's cave and the dural sheath of the trigeminal nerve are important from a clinical point of view. 18,[26][27][28] Ossification of the tentorium cerebelli over the trigeminal notch (ossification of the pPCL) should be taken into account during surgical decompression of the trigeminal nerve. 11,18 The oculomotor triangle is a space formed by the pPCL, together with some other structures, that exposes the distal intracavernous carotid artery; it is an important access corridor to the medial compartment of the cavernous sinus and for approaches to the interpeduncular fossa.…”

Ossification of the roof of the porus trigeminus with duplicated abducens nerve

“…These etiologies may manifest as symptomatically identical (i.e., excruciating neuropathic pain during stimulation of the face or oral cavity, and external and middle ear); therefore, magnetic resonance imaging and computed tomography (CT) angiography should be employed for preoperative neurodiagnostics. Notably, the tentorium cerebelli is susceptible to age-related ossification and have been observed throughout the tentorium cerebelli and other dura mater with no discrete zones predisposed to ossification [910]. Kıroğlu et al [9] reports that tentorial, falcian, and dural ossifications occur in 10% of elderly individuals.…”