Imaging study in etiologic diagnosis of trigeminal neuralgia / 中华神经科杂志

ABSTRACT

Objective To study the clinical significance of routine MRI and 3 dimensional time of flight magnetic resonance angiography (3D-TOF-MRA) for the pathogenesis of Trigeminal neuralgia (TN) Methods 32 patients with TN and 32 controls were observed by MRI and 3D-TOF-MRA by the enhancement of DTPA Diagnosis of the presence of compressions in the root exit zone (REZ) of the Trigeminal nerves were carried out by two radiologist on an independent console Results (1) In patients studied, compressions of the REZ of the nerves were detected with 29 on symptomatic sides (90 63%), neurovascular on 25 sides and tumor on 4 sides, and 2 on the asymptomatic sides(6 25%, all neurovascular) In the controls, 3 sides (4 26%, all neurovascular) were involved in the compressions of the REZ of the Trigeminal nerves (2) In 25 cases with TN of neurovascular etiology, the offending vessels were the superior cerebellar arteries in 17 cases (68%), anterior inferior cerebellar arteries in 2 cases, vertebral artery (VA) in 1 cases, difficultly identified vessels in 2 cases, vein in 2 cases, vascular malformation in 1 case (3) The RR of microvascular and tumor compressions which cause TN were 36 74 (4) The real microvascular compression and entrapping were only detected on the symptomatic sides of TN in 13 patients (52%) Conclusion MRI and 3D-TOF-MRA appeared to be the best imaging test for the pathogenesis of TN now The major causes of TN might be different neurovascular and tumor compressions in the REZ of the fifth cranial nerve, with real compression, entrapping or tight contact