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Trigeminal nerve - artery contact in people without trigeminal neuralgia - MR study.

Michał Adamczyk, Tomasz Bulski, J Sowińska, Artur Furmanek, Monika Bekiesińska‐Figatowska

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Abstract

BACKGROUND: Neurovascular conflict is regarded as the most common cause of idiopathic trigeminal neuralgia. It is suspected that a blood vessel in contact with the root entry zone of a trigeminal nerve causes its irritation. The aim of the study was to evaluate how signs of neurovascular conflict can be found in people without trigeminal neuralgia MATERIAL/METHODS: The study was conducted retrospectively. The authors analyzed MR examinations of 60 patients (120 nerves), aged 22-77 years, who did not have trigeminal neuralgia or related symptoms. Nerve-artery contact at the root entry zone of a trigeminal nerve, nerve deformation, and atrophy were searched for in angio-3D-TOF images (slice thickness: 1 mm). RESULTS: Contact between a trigeminal nerve and an artery was found in 30 cases (25% of nerves). The blood vessel was parallel to the nerve root in 14 cases (11.7%) and crossed it at a right or acute angle in 15 cases (12.5%). Contact between artery and atrophic nerve was found in one case. Modeling of the trigeminal nerve by an artery was not found. CONCLUSIONS: Contact between a trigeminal nerve root and an artery in the prepontine cistern is a frequently seen anatomical variant. Therefore, detection of such a variant is not equivalent to finding the cause of a patient's complaints.

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What this paper is about

BACKGROUND: Neurovascular conflict is regarded as the most common cause of idiopathic trigeminal neuralgia. It is suspected that a blood vessel in contact with the root entry zone of a trigeminal nerve causes its irritation. The aim of the study was to evaluate how signs of neurovascular conflict can be found in people without trigeminal neuralgia MATERIAL/METHODS: The study was conducted retrospectively. The authors analyzed MR examinations of 60 patients (120 nerves), aged 22-77 years, who did not have trigeminal neuralgia or related symptoms. Nerve-artery contact at the root entry zone of a trigeminal nerve, nerve deformation, and atrophy were searched for in angio-3D-TOF images (slice thickness: 1 mm). RESULTS: Contact between a trigeminal nerve and an artery was found in 30 cases (25% of nerves). The blood vessel was parallel to the nerve root in 14 cases (11.7%) and crossed it at a right or acute angle in 15 cases (12.5%). Contact between artery and atrophic nerve was found in one case. Modeling of the trigeminal nerve by an artery was not found. CONCLUSIONS: Contact between a trigeminal nerve root and an artery in the prepontine cistern is a frequently seen anatomical variant. Therefore, detection of such a variant is not equivalent to finding the cause of a patient's complaints.

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Available abstract

BACKGROUND: Neurovascular conflict is regarded as the most common cause of idiopathic trigeminal neuralgia. It is suspected that a blood vessel in contact with the root entry zone of a trigeminal nerve causes its irritation. The aim of the study was to evaluate how signs of neurovascular conflict can be found in people without trigeminal neuralgia MATERIAL/METHODS: The study was conducted retrospectively. The authors analyzed MR examinations of 60 patients (120 nerves), aged 22-77 years, who did not have trigeminal neuralgia or related symptoms. Nerve-artery contact at the root entry zone of a trigeminal nerve, nerve deformation, and atrophy were searched for in angio-3D-TOF images (slice thickness: 1 mm). RESULTS: Contact between a trigeminal nerve and an artery was found in 30 cases (25% of nerves). The blood vessel was parallel to the nerve root in 14 cases (11.7%) and crossed it at a right or acute angle in 15 cases (12.5%). Contact between artery and atrophic nerve was found in one case. Modeling of the trigeminal nerve by an artery was not found. CONCLUSIONS: Contact between a trigeminal nerve root and an artery in the prepontine cistern is a frequently seen anatomical variant. Therefore, detection of such a variant is not equivalent to finding the cause of a patient's complaints.

Key concepts: Medicine, Trigeminal neuralgia, Trigeminal nerve, Neurovascular bundle, Nerve root, Anatomy, Anesthesia

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