Abstract
Most instances of idiopathic trigeminal neuralgia (TN) are caused by neurovascular contact (NVC) between the offending vessels and the affected trigeminal nerve. Pre-treatment analysis of the MR imaging findings on the severity of the NVC may predict the outcomes of microvascular decompression (MVD) surgery or radiosurgical treatment. In order to visualize the spatial relationships of the NVC, we have developed a method for three-dimensional (3-D) magnetic resonance (MR) multi-fusion imaging, reconstructed with a perspective volume-rendering algorithm, by compositing co-registered data sets of 3-D MR cisternograms, 3-D MR angiograms (non-contrasted and contrast-enhanced), and 3-D computed tomographic (CT) angiograms in a single 3-D image. Technical aspects of the fusion imaging were documented with some comments regarding the MR sequences to characterize the NVC. Severity analysis of the NVC revealed that the NVC in the affected trigeminal nerve was observed more frequently and much more severely than that at the contra-lateral and normal nerves in controls. Pre-operative MVD surgical simulation and inner-view observation from inside the nerve were depicted for the virtual reality. Moreover, comparative fusion images were reconstructed by superimposing the post-MVD images over pre-MVD simulation, which may confirm the success of the nerve decompression by surgical treatment. Consequently, the 3-D MR multi-fusion imaging may be useful for adjunctive diagnosis, planning of the best treatment strategy, and post-treatment follow-up in patients with TN.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Amador N, Pollock BE (2008) Repeat posterior fossa exploration for patients with persistent or recurrent idiopathic trigeminal neuralgia. J Neurosurg 108:916–920
Anderson VC, Berryhill PC, Sandquist MA, Ciaverella DP, Nesbit GM, Burchiel KJ (2006) High-resolution three-dimensional magnetic resonance angiography and three-dimensional spoiled gradient-recalled imaging in the evaluation of neurovascular compression in patients with trigeminal neuralgia: a double-blinded pilot study. Neurosurgery 58:666–673
Bennetto L, Patel NK, Fuller G (2007) Trigeminal neuralgia and its management. BMJ 334:201–205
Chávez GR, Antonio AF, De Salles AAF, Solberg TD, Pedroso A, Espinoza D, Villablanca P (2005) Three-dimensional fast imaging employing steady-state acquisition magnetic resonance imaging for stereotactic radiosurgery of trigeminal neuralgia. Neurosurgery 56:E628
Ichikawa T, Agari T, Kurozumi K, Maruo T, Satoh T, Date I (2011) ‘Double-stick tape’ technique for transposition of an offending vessel in microvascular decompression: technical case report. Neurosurgery 68:onsE377–382
Ishikawa M, Nishi S, Aoki T (2002) Operative findings in cases of trigeminal neuralgia without vascular compression: Proposal of a different mechanism. J Clin Neurosci 9:200–204
Jannetta PJ (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia: definitive microsurgical treatment and results in 117 patients. Neurochirurgia 20:145–154
Leal PRL, Hermier M, Froment JC, Souza MA, Cristino-Filho G, Sindou M (2010) Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Acta Neurochir 152:817–825
Miller J, Acar F, Halilton, B, Burchiel K (2008) Preoperative visualization of neurovascular anatomy in trigeminal neuralgia. J Neurosurg 108:477–482
Miller J, Acar F, Halilton, B, Burchiel K (2009) Radiographic evaluation of trigeminal neurovascular compression in patients with and without trigeminal neuralgia. J Neurosurg 110:627–632
Naraghi R, Hastreiter P, Tomandl B, Bonk A, Huk W, Fahlbusch R (2004) Three-dimensional visualization of neurovascular relationships in the posterior fossa: technique and clinical application. J Neurosurg 100:1025–1035
Satoh T, Ekino C, Ohsako C (2004) Transluminal color-coded three-dimensional magnetic resonance angiography for visualization of signal intensity distribution pattern within an unruptured cerebral aneurysm: preliminarily assessment with anterior communicating artery aneurysms. Neuroradiology 46:628–634
Satoh T, Onoda K, Date I (2007a) Preoperative simulation for microvascular decompression in patients with idiopathic trigeminal neuralgia: visualization with three-dimensional magnetic resonance cisternogram and angiogram fusion imaging. Neurosurgery 60:104–114
Satoh T, Onoda K, Date I (2007b) Fusion imaging of three-dimensional magnetic resonance cisternograms and angiograms for the assessment of microvascular decompression in patients with hemifacial spasms. J Neurosurg 106:82–89
Satoh T, Omi M, Nebeshima M, Onoda K, Date I (2009) Severity analysis of neurovascular contact in patients with trigeminal neuralgia: assessment with the inner view of the 3D MR cisternogram and angiogram fusion imaging. AJNR Am J Neuroradiol 30:603–609
Sheehan JP, Ray DK, Monteith S, Yen CP, Lesnick J, Kersh R, Schlesinger D (2010) Gamma Knife radiosurgery for trigeminal neuralgia: the impact of magnetic resonance imaging-detected vascular impingement of the affected nerve. J Neurosurg 113:53–58
Sindou M, Leston J, Decullier E, Chapuis F (2007) Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. J Neurosurg 107:114–1163
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Satoh, T., Onoda, K., Date, I. (2012). Trigeminal Neuralgia: Diagnosis Using 3-D Magnetic Resonance Multi-Fusion Imaging. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 4. Tumors of the Central Nervous System, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1706-0_20
Download citation
DOI: https://doi.org/10.1007/978-94-007-1706-0_20
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-1705-3
Online ISBN: 978-94-007-1706-0
eBook Packages: MedicineMedicine (R0)