Necessity of Magnetic Resonance Imaging (MRI) using an appropriate sequence for diagnosis of trigeminal neuralgia associated with intracranial tumor

Aims: Trigeminal neuralgia is generally caused by neurovascular compression. In rare cases intracranial tumors may also lead to this condition. The present study was conducted to identify clinical symptoms and testing methods that are useful for early detection of trigeminal neuralgia associated with intracranial tumor. Methods: Five patients with trigeminal neuralgia suspected to be due to intracranial tumor, who visited our department for the first time during the period between February 2007 and March 2009, were examined. We analyzed the medical records and MRI findings of these patients. The clinical symptoms of subjects were compared to those presented at the International Classification of Headache Disorders. Results: There were no feature symptoms to trigeminal neuralgia caused by intracranial tumors compared with trigeminal neuralgia in general. None of the patients complained of spontaneous headache and nausea, which are clinical symptoms characteristic of brain tumor. Head MRI at our hospital was the most accurate method to detect intracranial tumors. Finally four of five patients received brain surgery to remove tumors. Conclusion: Small tumors and roots of the trigeminal nerve may not create accurate images by regular head MRI. Therefore, MRI using the imaging sequence which enables accurate visualization of roots of the trigeminal nerve is essential to confirm the presence of tumors in patients with suspected trigeminal neuralgia.