gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Additional morphological criteria concerning the neurovascular compression theory in trigeminal neuralgia observed with high resolution MRI

Zusätzliche morphologische Kriterien bezüglich der neurovaskulären Kompressionstheorie bei Trigeminus-Neuralgie untersucht mit hochauflösender Kernspintomographie

Meeting Abstract

  • corresponding author D. Rasche - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • B. Kress - Abteilung Neuroradiologie, Neurologische Klinik, Universitätsklinikum Heidelberg
  • C. Stippich - Abteilung Neuroradiologie, Neurologische Klinik, Universitätsklinikum Heidelberg
  • E. Nennig - Abteilung Neuroradiologie, Neurologische Klinik, Universitätsklinikum Heidelberg
  • A. Unterberg - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • V. M. Tronnier - Neurochirurgische Klinik, Universitätsklinikum Heidelberg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-09.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0037.shtml

Published: May 4, 2005

© 2005 Rasche et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

The pathophysiological cause of idiopathic trigeminal neuralgia (TN) is still unknown and the discussion about the neurovascular compression theory is going on. Preoperative magnetic resonance imaging is performed to exclude a symptomatic cause like a tumour or inflammation. Efforts are made to visualise a neurovascular compression of the trigeminal nerve root near the brainstem. In this prospective study high resolution MRI was performed and additional morphological criteria like nerve atrophy, volume of the parapontine cistern etc. were measured.

Methods

50 patients with TN and 50 healthy controls were examined using a 1.5 Tesla Scanner (Symphony, Siemens, Germany) and a high resolution T2-TrueFisp sequence with a slice thickness of 0.3 mm to create a 3D-volume. Also a T1-Flash-3D-vibe sequence (+/- gadolinium iv) with 0.9 mm slice thickness was acquired.

Results

A neurovascular conflict was found in 45/50 patients with TN (90%) and 38/50 healthy controls (76%). In 37 patients with TN volumetry was performed and identified a significant smaller volume of the involved nerve and ipsilateral pontomesencephalic cistern (p<0.05). In all patients the angle of the trigeminal nerve from its entry point in the pons to the gasserian ganglion was significantly steeper compared with the non-affected side (p<0.05).

Conclusions

In patients with TN high resolution MRI can demonstrate specific morphological differences of the affected and non-affected trigeminal nerves. A smaller volume of the nerve, pontomesencephalic cistern and a steeper angle in the cistern have to be taken into account as additional criteria supporting the neurovascular compression theory.