Madoka Suzuki1, Norio Yoshino2, Masahiko Shimada1, Akemi Tetsumura1, Tomoka Matsumura3, Haruhisa Fukayama3, Tohru Kurabayashi1. 1. Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University. 2. Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University. Electronic address: norio.orad@tmd.ac.jp. 3. Department of Anesthesiology and Clinical Physiology, Graduate School, Tokyo Medical and Dental University.
Abstract
OBJECTIVES: Neurovascular compression (NVC) of the trigeminal nerve is the primary cause of trigeminal neuralgia (TN) but is known to occur in both symptomatic and asymptomatic nerves. The purposes of this study were to evaluate the relationship between the magnetic resonance imaging (MRI) findings regarding the site of NVC and the manifestation of TN symptoms. METHODS: In 147 patients with unilateral TN, the presence or absence of NVC was evaluated on MRI in both symptomatic and asymptomatic nerves. In cases with NVC, the shortest distance from the trigeminal nerve root to the responsible vessel was measured. RESULTS: The mean distance from the trigeminal nerve root to the site of NVC in asymptomatic nerves (3.85 ± 2.69 mm) was significantly greater than that in symptomatic nerves (0.94 ± 1.27 mm). When the distance was 3 mm or less, the rate of the manifestation of TN symptoms was 83.1% (103/124). On the other hand, it was only 19.6% (9/46) in cases with a distance of greater than 3 mm. CONCLUSIONS: Whether or not NVC of the trigeminal nerve was symptomatic was closely related to the distance from the trigeminal nerve root to the responsible blood vessel.
OBJECTIVES: Neurovascular compression (NVC) of the trigeminal nerve is the primary cause of trigeminal neuralgia (TN) but is known to occur in both symptomatic and asymptomatic nerves. The purposes of this study were to evaluate the relationship between the magnetic resonance imaging (MRI) findings regarding the site of NVC and the manifestation of TN symptoms. METHODS: In 147 patients with unilateral TN, the presence or absence of NVC was evaluated on MRI in both symptomatic and asymptomatic nerves. In cases with NVC, the shortest distance from the trigeminal nerve root to the responsible vessel was measured. RESULTS: The mean distance from the trigeminal nerve root to the site of NVC in asymptomatic nerves (3.85 ± 2.69 mm) was significantly greater than that in symptomatic nerves (0.94 ± 1.27 mm). When the distance was 3 mm or less, the rate of the manifestation of TN symptoms was 83.1% (103/124). On the other hand, it was only 19.6% (9/46) in cases with a distance of greater than 3 mm. CONCLUSIONS: Whether or not NVC of the trigeminal nerve was symptomatic was closely related to the distance from the trigeminal nerve root to the responsible blood vessel.
Authors: Nicholas L Deep; Geoffrey P Fletcher; Kent D Nelson; Ameet C Patel; David M Barrs; Bernard R Bendok; Joseph M Hoxworth Journal: J Neurol Surg B Skull Base Date: 2016-05-27