Journal of Neurology

, Volume 242, Issue 2, pp 93–98 | Cite as

The significance of three-dimensional MR-defined neurovascular compression for the pathogenesis of trigeminal neuralgia

  • Harald Masur
  • Karsten Papke
  • Georg Bongartz
  • Knut Vollbrecht
Original Communication

Abstract

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 words

Three-dimensional magnetic resonance imaging Trigeminal nerve neuralgia Neurovascular compression 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Baldwin NG, Sahni KS, Jensen ME, Pieper DR, Anderson RL, Young HF (1991) Association of vascular compression in trigeminal neuralgia versus other “facial pain syndromes” by magenetic resonance imaging. Surg Neurol 36:447–452PubMedGoogle Scholar
  2. 2.
    Cidlinsky K, Stenglein C, Braun M (1992) Neurovaskuläre Kompression des VIII. Hirnnerven: direkte Darstellung durch MR-Angiographie. Klin Neuroradiol 2:6–10Google Scholar
  3. 3.
    Furuya Y, Ryu H, Uemura K, Sugiyama K, Isoda H, Hasegawa S, Takahashi M, Kaneko M (1992) MRI of intracranial neurovascular compression. J Comput Assist Tomogr 16:503–505PubMedGoogle Scholar
  4. 4.
    Hamlyn PJ, King TT (1992) Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study. J Neurosurg 76:948–954PubMedGoogle Scholar
  5. 5.
    Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26:159–162PubMedGoogle Scholar
  6. 6.
    Jannetta PJ (1979) Treatment of trigeminal neuralgia. Neurosurgery 4:93–94PubMedGoogle Scholar
  7. 7.
    Magnaldi S, Cecconi P, Skrap M, Ricci C, Cova MA, Pozzi-Mucelli RS (1992) Magnetic resonance in trigeminal neuralgia. Radiol Med Torino 83:700–705PubMedGoogle Scholar
  8. 8.
    Matsumoto S, Kishikawa T, Kudo S, Matsuo Y, Totoki T, Harano K (1991) Magnetic resonance imaging of idiopathic trigeminal neuralgia. Nippon Igaku Hoshasen Gakkai Zasshi 51:91–93PubMedGoogle Scholar
  9. 9.
    Møller AR (1991) The cranial nerve vascular compression syndrome. I. A review of treatment. Acta Neurochir (Wien) 113:18–23Google Scholar
  10. 10.
    Møller AR (1991) The cranial nerve vascular compression syndrome. II. A review of pathophysiology. Acta Neurochir (Wien) 113:24–30Google Scholar
  11. 11.
    Sens MA, Higer HP (1991) MRI of trigeminal neuralgia: initial clinical results in patients with vascular compression. Neurosurg Rev 14:69–73PubMedGoogle Scholar
  12. 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. 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

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Harald Masur
    • 1
  • Karsten Papke
    • 1
  • Georg Bongartz
    • 2
  • Knut Vollbrecht
    • 2
  1. 1.Department of NeurologyUniversity of MünsterMünsterGermany
  2. 2.Institute for Clinical RadiologyUniversity of MünsterMünsterGermany

Personalised recommendations