The significance of three-dimensional MR-defined neurovascular compression for the pathogenesis of trigeminal neuralgia
Three-dimensional MR tomography was used to examine the relationship between symptoms of trigeminal neuralgia and neurovascular compression of the nerve in 18 patients. The intensity of neurovascular interaction was classified according to neuroradiological criteria. We found that a radiologically defined compression or dislocation of the nerve by an artery was always associated with symptoms of trigeminal neuralgia. A simple contanct between vessel and nerve, however, was also observed on the asymptomatic sides of 10 out of 18 patients. In 6 of 18 patients, in contrast, trigeminal neuralgia was present in spite of the absence of neurovascular contact. In accordance with a cited study based on autopsy and intraoperative findings, our findings indicate that, in a certain proportion of cases, trigeminal neuralgia may be caused by neurovascular compression alone, whereas in other cases, other pathogenetic factors may be involved to a varying degree or be even exclusively responsible for the development of trigeminal neuralgia. The possible significance of the method for a preoperative estimation of the success of microvascular decompression of the trigeminal nerve is discussed.
Key wordsThree-dimensional magnetic resonance imaging Trigeminal nerve neuralgia Neurovascular compression
Unable to display preview. Download preview PDF.
- 2.Cidlinsky K, Stenglein C, Braun M (1992) Neurovaskuläre Kompression des VIII. Hirnnerven: direkte Darstellung durch MR-Angiographie. Klin Neuroradiol 2:6–10Google Scholar
- 9.Møller AR (1991) The cranial nerve vascular compression syndrome. I. A review of treatment. Acta Neurochir (Wien) 113:18–23Google Scholar
- 10.Møller AR (1991) The cranial nerve vascular compression syndrome. II. A review of pathophysiology. Acta Neurochir (Wien) 113:24–30Google Scholar
- 12.Sindou M (1991) Does microsurgical vascular decompression for trigeminal neuralgia work through a neo-compressive mechanism? Anatomical-surgical evidence for a decompressive effect. Acta Neurochir [Suppl] (Wien) 52:127–129Google Scholar
- 13.Yamaki T, Hashi K, Niwa J, Tanabe S, Nakagawa T, Nakamura T, Uede T, Tsuruno T (1992) Results of reoperation for failed microvascular decompression. Acta Neurochir (Wien) 115:1–7Google Scholar