Skip to main content
SpringerLink
Log in
Book cover

Pain Imaging pp 83–118Cite as

Imaging of Trigeminal Neuralgia

  • Chapter
  • First Online:

  • 1771 Accesses

Abstract

Trigeminal neuralgia is one of the most frequent neuropathy of the cranial nerves, whose prevalence has been reported between 0.03% and 0.3% in the general population.

This condition is a communal manifestation of several possible etiologies. The classical type of trigeminal neuralgia is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain in the distribution of one or more branches of the trigeminal nerve, with no cause other than a neurovascular compression.

Secondary trigeminal neuralgia is the term used to group a large amount of different diseases, which are alike in developing the symptoms of trigeminal neuralgia, due to an insult to the V CN which triggers the complex pathogenesis of pain. These conditions include inflammatory diseases, infections, neoplasms, autoimmune diseases, vascular diseases other than neurovascular conflict, and treatment-related disorders. Generally, the possible mechanisms which lead to the development of neuralgia include nerve distortion/compression by an external mass or damage to the nerve fibers due to an acute or chronic insult.

The radiological investigation plays a pivotal role in the diagnosis of trigeminal neuralgia, and MRI constitutes the gold imaging standard in most cases.

The trigeminal nerve is a mixed sensory-motor nerve which can be divided anatomically into five segments: brainstem segment, cisternal segment, Meckel’s cave segment, cavernous sinus segment, and extracranial segment.

In this paragraph, an anatomy-based imaging approach is proposed to investigate the many causes of trigeminal neuralgia, highlighting the importance of choosing the appropriate sequences and parameters, in the light of a target-suited protocol.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Binder D, Sonne D, Fischbein N. Cranial nerves. New York: Thieme; 2010.

    Google Scholar 

  2. Borges A, Casselman J. Imaging the trigeminal nerve. Eur J Radiol. 2010;74:323–40.

    Article  PubMed  Google Scholar 

  3. Blitz A, Choudhri A, Chonka Z, Ilica A, Macedo L, Chhabra A, et al. Anatomic considerations, nomenclature, and advanced cross-sectional imaging techniques for visualization of the cranial nerve segments by MR imaging. Neuroimaging Clin N Am. 2014;24:1–15.

    Article  PubMed  Google Scholar 

  4. Tomii M, Onoue H, Yasue M, Tokudome S, Abe T. Microscopic measurement of the facial nerve root exit zone from central glial myelin to peripheral Schwann cell myelin. J Neurosurg. 2003;99:121–4.

    Article  PubMed  Google Scholar 

  5. Campos-Benitez M, Kaufmann A. Neurovascular compression findings in hemifacial spasm. J Neurosurg. 2008;109:416–20.

    Article  PubMed  Google Scholar 

  6. Gudmundsson K, Rhoton A, Rushton J. Detailed anatomy of the intracranial portion of the trigeminal nerve. J Neurosurg. 1971;35:592–600.

    Article  CAS  PubMed  Google Scholar 

  7. Haller S, Etienne L, Ko vari E, Varoquaux A, Urbach H, Becker M. Imaging of neurovascular compression syndromes: trigeminal neuralgia, hemifacial spasm, vestibular paroxysmia, and glossopharyngeal neuralgia. Am J Neuroradiol. 2016;37:1384–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Lang J. Clinical anatomy of the head. Berlin: Springer-Verlag; 1983.

    Book  Google Scholar 

  9. Williams LS, Schmalfuss IM, Sistrom CL, Inoue T, Tanaka R, Seoane ER, et al. MR imaging of the trigeminal ganglion, nerve, and the perineural vascular plexus: normal appearance and variants with correlation to cadaver specimens. Am J Neuroradiol. 2003;24:1317–23.

    PubMed  PubMed Central  Google Scholar 

  10. Borges A, Casselman J. Imaging the cranial nerves part I: methodology, infectious and inflammatory, traumatic and congenital lesions. Eur Radiol. 2007;175:2112–25.

    Article  Google Scholar 

  11. Penn R, Abemayor E, Nabili V, Bhuta S, Kirsch C. Perineural invasion detected by high-field 3.0-T magnetic resonance imaging. Am J Otolaryngol. 2010;31:482–4.

    Article  PubMed  Google Scholar 

  12. Casselman J, Kuhweide R, Deimling M, Ampe W, Dehaene I, Meeus L. Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle. Am J Neuroradiol. 1993;14:47–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Sheth S, Branstetter BF IV, Escott EJ. Appearance of normal cranial nerves on steady-state free precession MR images1. RadioGraphics. 2009;29:1045–55.

    Article  PubMed  Google Scholar 

  14. Casselman J, Mermuys K, Delanote J, Ghekiere J, Coenegrachts K. MRI of the cranial nerves—more than meets the eye: technical considerations and advanced anatomy. Neuroimaging Clin N Am. 2008;18:197–231.

    Article  PubMed  Google Scholar 

  15. Seeburg D, Northcutt B, Aygun N, Blitz A. The role of imaging for trigeminal neuralgia. Neurosurgery Clin N Am. 2016;27:315–26.

    Article  Google Scholar 

  16. The International Classification of Headache Disorders. 3rd ed. (Beta version) [Internet]. ICHD3b. 2017 [cited 22 November 2017]. Available from: https://www.ichd-3.org/.

  17. Akter M, Hirai T, Minoda R, Murakami R, Saiki S, Okuaki T, et al. Diffusion tensor tractography in the head-and-neck region using a clinical 3-T MR scanner. Acad Radiol. 2009;16:858–65.

    Article  PubMed  Google Scholar 

  18. Mazhari A. Multiple sclerosis-related pain syndromes: an imaging update. Curr Pain Headache Rep. 2016;20:63.

    Article  PubMed  Google Scholar 

  19. Tekkok I, Sumer M. Bilateral trigeminal neuralgia and Charcot-Marie-Tooth disease: diagnosis and successful microsurgical treatment of bilateral neurovascular compression. Zentralbl Neurochir – Cent Eur Neurosurg. 2008;69:148–51.

    CAS  Google Scholar 

  20. Truini A, Prosperini L, Calistri V, Fiorelli M, Pozzilli C, Millefiorini E, et al. A dual concurrent mechanism explains trigeminal neuralgia in patients with multiple sclerosis. Neurology. 2016;86:2094–9.

    Article  PubMed  Google Scholar 

  21. Gass A, Kitchen N, MacManus D, Moseley I, Hennerici M, Miller D. Trigeminal neuralgia in patients with multiple sclerosis: lesion localization with magnetic resonance imaging. Neurology. 1997;49:1142–4.

    Article  CAS  PubMed  Google Scholar 

  22. Mills R, Young C, Smith E. Central trigeminal involvement in multiple sclerosis using high-resolution MRI at 3 T. Br J Radiol. 2010;83:493–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Bathla G, Hegde A. The trigeminal nerve: an illustrated review of its imaging anatomy and pathology. Clin Radiol. 2013;68:203–13.

    Article  CAS  PubMed  Google Scholar 

  24. Becker M, Kohler R, Vargas M, Viallon M, Delavelle J. Pathology of the trigeminal nerve. Neuroimaging Clin N Am. 2008;18:283–307.

    Article  PubMed  Google Scholar 

  25. Haanpaa M, Dastidar P, Weinberg A, Levin M, Miettinen A, Lapinlampi A, et al. CSF and MRI findings in patients with acute herpes zoster. Neurology. 1998;51:1405–11.

    Article  CAS  PubMed  Google Scholar 

  26. D’Amico A, Russo C, Ugga L, Mazio F, Capone E, D’Arco F, et al. Can pontine trigeminal T2-hyperintensity suggest herpetic etiology of trigeminal neuralgia? Quant Imaging Med Surg. 2016;6:490–5.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Dueland A, Ranneberg-Nilsen T, Degré M. Detection of latent varicella zoster virus DNA and human gene sequences in human trigeminal ganglia by in situ amplification combined with in situ hybridization. Arch Virol. 1995;140:2055–66.

    Article  CAS  PubMed  Google Scholar 

  28. Burger K, Tuhrim S, Naidich T. Brainstem vascular stroke anatomy. Neuroimaging Clin N Am. 2005;15:297–324.

    Article  PubMed  Google Scholar 

  29. Tatu L, Moulin T, Vuillier F, Bogousslavsky J. Arterial territories of the human brain. Front Neurol Neurosci. 2012;30:99–110.

    Article  PubMed  Google Scholar 

  30. Fitzek S, Baumgartner U, Marx J, Joachimski F, Axer H, Witte OW, et al. Pain and itch in Wallenberg’s syndrome: anatomical-functional correlations. Suppl Clin Neurophysiol. 2006;58:187–94.

    Article  PubMed  Google Scholar 

  31. Ordás C, Cuadrado M, Simal P, Barahona R, Casas J, Matías-Guiu Antem J, et al. Wallenberg’s syndrome and symptomatic trigeminal neuralgia. J Headache Pain. 2011;12:377–80.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Balestrino M, Leandri M. Trigeminal neuralgia in pontine ischaemia. J Neurol Neurosurg Psychiatry. 1997;62:297–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Golby A, Norbash A, Silverberg G. Trigeminal neuralgia resulting from infarction of the root entry zone of the trigeminal nerve: case report. Neurosurgery. 1998;43:620–3.

    Article  CAS  PubMed  Google Scholar 

  34. Kim J, Kang J, Lee M. Trigeminal neuralgia after pontine infarction. Neurology. 1998;51:1511–2.

    Article  CAS  PubMed  Google Scholar 

  35. Peker S, Akansel G, Sun I, Pamir N. Trigeminal neuralgia due to pontine infarction. Headache J Head Face Pain. 2004;44:1043–5.

    Article  Google Scholar 

  36. Katsuno M, Teramoto A. Secondary trigeminal neuropathy and neuralgia resulting from pontine infarction. J Stroke Cerebrovasc Dis. 2010;19:251–2.

    Article  PubMed  Google Scholar 

  37. Nakamizo T, Koide T, Miyazaki H. Progressive intracranial vertebral artery dissection presenting with isolated trigeminal neuralgia-like facial pain. Case Rep Neurol Med. 2015;2015:1–4.

    Google Scholar 

  38. Osborn A, Salzman K, Jhaveri M. Diagnostic imaging. Philadelphia: Elsevier; 2016.

    Google Scholar 

  39. Adachi K, Hasegawa M, Hayashi T, Nagahisa S, Hirose Y. A review of cavernous malformations with trigeminal neuralgia. Clin Neurol Neurosurg. 2014;125:151–4.

    Article  PubMed  Google Scholar 

  40. Barkovich A. Diagnostic imaging: pediatric neuroradiology. 2nd ed. Philadelphia: Elsevier Health Sciences; 2014.

    Google Scholar 

  41. Hartmann M, Heiland S, Harting I, Tronnier VM, Sommer C, Ludwig R, et al. Distinguishing of primary cerebral lymphoma from high-grade glioma with perfusion-weighted magnetic resonance imaging. Neurosci Lett. 2003;338:119–22.

    Article  CAS  PubMed  Google Scholar 

  42. Haldorsen I, Espeland A, Larsson E. Central nervous system lymphoma: characteristic findings on traditional and advanced imaging. Am J Neuroradiol. 2010;32:984–92.

    Article  PubMed  Google Scholar 

  43. Liu J, Yuan Y, Zhang L, Fang Y, Liu H, Yu Y. Hemifacial spasm and trigeminal neuralgia in Chiari’s I malformation with hydrocephalus: case report and literature review. Clin Neurol Neurosurg. 2014;122:64–7.

    Article  PubMed  Google Scholar 

  44. Zhang W, Chen M, Zhang W. Trigeminal neuralgia due to dandy-walker syndrome. J Craniofac Surg. 2013;24:1457–9.

    Article  PubMed  Google Scholar 

  45. Jannetta P, Mclaughlin M, Casey K. Technique of microvascular decompression. Neurosurg Focus. 2005;18:1–5.

    Google Scholar 

  46. Love S. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124:2347–60.

    Article  CAS  PubMed  Google Scholar 

  47. Guclu B, Sindou M, Meyronet D, Streichenberger N, Simon E, Mertens P. Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharyngeal nerves: comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes. Acta Neurochir. 2011;153:2365–75.

    Article  PubMed  Google Scholar 

  48. Sindou M, Howeidy T, Acevedo G. Anatomical observations during microvascular decompression for idiopathic trigeminal neuralgia (with correlations between topography of pain and site of the neurovascular conflict). Prospective study in a series of 579 patients. Acta Neurochir. 2002;144:1–13.

    Article  CAS  PubMed  Google Scholar 

  49. Ros de San Pedro J. Posterior communicating artery aneurysms causing facial pain: a comprehensive review. Clin Neurol Neurosurg. 2017;160:59–68.

    Article  PubMed  Google Scholar 

  50. de Bondt B, Stokroos R, Casselman J. Persistent trigeminal artery associated with trigeminal neuralgia: hypothesis of neurovascular compression. Neuroradiology. 2006;49:23–6.

    Article  PubMed  Google Scholar 

  51. García-Pastor C, López-González F, Revuelta R, Nathal E. Trigeminal neuralgia secondary to arteriovenous malformations of the posterior fossa. Surg Neurol. 2006;66:207–11.

    Article  PubMed  Google Scholar 

  52. Matsushima T, Huynh-Le P, Miyazono M. Trigeminal neuralgia caused by venous compression. Neurosurgery. 2004;55:334–7.

    Article  PubMed  Google Scholar 

  53. Antonini G, Di Pasquale A, Cruccu G, Truini A, Morino S, Saltelli G, et al. Magnetic resonance imaging contribution for diagnosing symptomatic neurovascular contact in classical trigeminal neuralgia: a blinded case-control study and meta-analysis. Pain. 2014;155:1464–71.

    Article  PubMed  Google Scholar 

  54. Suzuki M, Yoshino N, Shimada M, Tetsumura A, Matsumura T, Fukayama H, et al. Trigeminal neuralgia: differences in magnetic resonance imaging characteristics of neurovascular compression between symptomatic and asymptomatic nerves. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119:113–8.

    Article  PubMed  Google Scholar 

  55. Harsha K, Kesavadas C, Chinchure S, Thomas B, Jagtap S. Imaging of vascular causes of trigeminal neuralgia. J Neuroradiol. 2012;39:281–9.

    Article  PubMed  Google Scholar 

  56. İldan F, Göçer A, Bağdatoğlu H, Uzuneyüpoğlu Z, Tuna M, Çetinalp E. Isolated trigeminal neuralgia secondary to distal anterior inferior cerebellar artery aneurysm. Neurosurg Rev. 1996;19:43–6.

    Article  PubMed  Google Scholar 

  57. Peluso J, van Rooij W, Sluzewski M, Beute G. Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment. Neuroradiology. 2007;49:747–51.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Pereira L, Nepomuceno L, Coimbra P, Oliveira Neto S, Natal M. Persistent trigeminal artery: angio-tomography and angio-magnetic resonance finding. Arq Neuro-Psiquiatr. 2009;67:882–5.

    Article  Google Scholar 

  59. Yoshino N, Akimoto H, Yamada I, Nagaoka T, Tetsumura A, Kurabayashi T, et al. Trigeminal neuralgia: evaluation of neuralgic manifestation and site of neurovascular compression with 3D CISS MR imaging and MR angiography. Radiology. 2003;228:539–45.

    Article  PubMed  Google Scholar 

  60. Herweh C, Kress B, Rasche D, Tronnier V, Troger J, Sartor K, et al. Loss of anisotropy in trigeminal neuralgia revealed by diffusion tensor imaging. Neurology. 2007;68:776–8.

    Article  CAS  PubMed  Google Scholar 

  61. Delfini R, Innocenzi G, Ciappetta P, Domenicucci M, Cantore G. Meningiomas of Meckelʼs cave. Neurosurgery. 1992;31:1000–7.

    CAS  PubMed  Google Scholar 

  62. Carvalho G, Matthies C, Tatagiba M, Eghbal R, Samii M. Impact of computed tomographic and magnetic resonance imaging findings on surgical outcome in petroclival meningiomas. Neurosurgery. 2000;47:1287–95.

    Article  CAS  PubMed  Google Scholar 

  63. Narro-Donate J, Huete-Allut A, Velasco-Albendea F, Escribano-Mesa J, Mendez-Román P, Masegosa-González J. Condroma adyacente al cavum de Meckel simulando un neurinoma del quinto par craneal. A propósito de un caso. Neurocirugía. 2016;27:144–8.

    Article  PubMed  Google Scholar 

  64. Leclercq D, Thiebaut J, Héran F. Trigeminal neuralgia. Diagn Interv Imaging. 2013;94:993–1001.

    Article  CAS  PubMed  Google Scholar 

  65. Zakrzewska JM. Trigeminal neuralgia. Clin Evid. 2002;7:1221–31.

    Google Scholar 

  66. Larrier D, Lee A. Anatomy of headache and facial pain. Otolaryngol Clin N Am. 2003;36:1041–53.

    Article  Google Scholar 

  67. Tortori-Donati P, Rossi A, Biancheri R. Pediatric neuroradiology. Berlin: Springer; 2005.

    Book  Google Scholar 

  68. Muzammil S, Leong K. A case of cerebellopontine angle epidermoid cyst presenting as trigeminal neuropathy. South Med J. 2009;102:534–6.

    Article  PubMed  Google Scholar 

  69. Furtado S, Hegde A. Trigeminal neuralgia due to a small Meckel’s cave epidermoid tumor: surgery using an extradural corridor. Skull Base. 2009;19:353–7.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Majoie C, Verbeeten B, Dol J, Peeters F. Trigeminal neuropathy: evaluation with MR imaging. RadioGraphics. 1995;15:795–811.

    Article  CAS  PubMed  Google Scholar 

  71. Patnana M, Sevrukov A, Elsayes K, Viswanathan C, Lubner M, Menias C. Inflammatory pseudotumor: the great mimicker. Am J Roentgenol. 2012;198:W217–27.

    Article  Google Scholar 

  72. Lui P, Fan Y, Wong S, Chan A, Wong G, Chau T, et al. Inflammatory pseudotumors of the central nervous system. Hum Pathol. 2009;40:1611–7.

    Article  CAS  PubMed  Google Scholar 

  73. Bangiyev L, Kornacki S, Mikolaenko I. Rare isolated trigeminal nerve sarcoidosis mimicking schwannoma. Clin Imaging. 2015;39:133–5.

    Article  PubMed  Google Scholar 

  74. Seidel E, Hansen C, Urban P, Vogt T, Muller-Forell W, Hopf H. Idiopathic trigeminal sensory neuropathy with gadolinium enhancement in the cisternal segment. Neurology. 2000;54:1191–2.

    Article  CAS  PubMed  Google Scholar 

  75. Fritz C, Rösler A, Heyden B, Braune H. Trigeminal neuralgia as a clinical manifestation of Lyme neuroborreliosis. J Neurol. 1996;243:367–8.

    Article  CAS  PubMed  Google Scholar 

  76. Hashmi M, Guha G, Saha B. Trigeminal neuralgia in an HIV patient. J Global Infect Dis. 2010;2:65.

    Article  Google Scholar 

  77. Pichiecchio A, Bergamaschi R, Tavazzi E, Romani A, Todeschini A, Bastianello S. Bilateral trigeminal enhancement on magnetic resonance imaging in a patient with multiple sclerosis and trigeminal neuralgia. Mult Scler J. 2007;13:814–6.

    Article  CAS  Google Scholar 

  78. Bird TD, Ott J, Giblett ER. Evidence for linkage of Charcot-Marie-Tooth neuropathy to the Duffy locus on chromosome 1. Am J Hum Genet. 1982;34:388–94.

    CAS  PubMed  PubMed Central  Google Scholar 

  79. Albayram S, Asik M, Hasiloglu Z, Dikici A, Erdemli H, Altintas A. Pathological contrast enhancement of the oculomotor and trigeminal nerves caused by intracranial hypotension syndrome. Headache J Head Face Pain. 2011;51:804–8.

    Article  Google Scholar 

  80. Friedman D. The pseudotumor cerebri syndrome. Neurol Clin. 2014;32:363–96.

    Article  PubMed  Google Scholar 

  81. Davenport R, Will R, Galloway P. Isolated intracranial hypertension presenting with trigeminal neuropathy. J Neurol Neurosurg Psychiatry. 1994;57:381.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Kouyialis A, Stranjalis G, Boviatsis E, Ziaka D, Bouras T, Sakas D. Recurrence of trigeminal neuralgia due to an acquired arachnoid cyst. J Clin Neurosci. 2008;15:1409–11.

    Article  CAS  PubMed  Google Scholar 

  83. Larson J, van Loveren H, Balko M, Tew J. Evidence of meningioma infiltration into cranial nerves: clinical implications for cavernous sinus meningiomas. J Neurosurg. 1995;83:596–9.

    Article  CAS  PubMed  Google Scholar 

  84. El-Kalliny M, van Loveren H, Keller J, Tew J. Tumors of the lateral wall of the cavernous sinus. J Neurosurg. 1992;77:508–14.

    Article  CAS  PubMed  Google Scholar 

  85. Wang M, Li G, Jia D, Shen J. Clinical characteristics and surgical outcomes of patients with interdural epidermoid cyst of the cavernous sinus. J Clin Neurosci. 2013;20:53–6.

    Article  CAS  PubMed  Google Scholar 

  86. Korchi A, Cuvinciuc V, Caetano J, Becker M, Lovblad K, Vargas M. Imaging of the cavernous sinus lesions. Diagn Interv Imaging. 2014;95:849–59.

    Article  CAS  PubMed  Google Scholar 

  87. Gazioğlu N, Tanriöver N, Tüzgen S. Pituitary tumour presenting with trigeminal neuralgia as an isolated symptom. Br J Neurosurg. 2000;14:579.

    Article  PubMed  Google Scholar 

  88. Faro S, Koenlgsberg R, Turtz A, Croul S. Melanocytoma of the cavernous sinus: CT and MR findings. Am J Neuroradiol. 1996;17:1087–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  89. Louis D, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee W, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131:803–20.

    Article  PubMed  Google Scholar 

  90. Pan H, Wang H, Fan Y. Intracranial meningeal melanocytoma associated with nevus of Ota. J Clin Neurosci. 2011;18:1548–50.

    Article  PubMed  Google Scholar 

  91. Goel A. Chordoma and chondrosarcoma: Relationship to the internal carotid artery. Acta Neurochir. 1995;133:30–5.

    Article  CAS  PubMed  Google Scholar 

  92. Som P, Curtin H. Head and neck imaging. St. Louis: Mosby; 2003.

    Google Scholar 

  93. Almefty K, Pravdenkova S, Colli B, Al-Mefty O, Gokden M. Chordoma and chondrosarcoma: similar, but quite different, skull base tumors. Cancer. 2007;110:2467–77.

    Article  Google Scholar 

  94. Smith A, Horkanyne-Szakaly I, Schroeder J, Rushing E. From the radiologic pathology archives: mass lesions of the dura: beyond meningioma—radiologic-pathologic correlation. RadioGraphics. 2014;34:295–312.

    Article  PubMed  Google Scholar 

  95. Starr C, Cha S. Meningioma mimics: five key imaging features to differentiate them from meningiomas. Clin Radiol. 2017;72:722–8.

    Article  CAS  PubMed  Google Scholar 

  96. Hakyemez B, Yildirim N, Erdoðan C, Kocaeli H, Korfali E, Parlak M. Meningiomas with conventional MRI findings resembling intraaxial tumors: can perfusion-weighted MRI be helpful in differentiation? Neuroradiology. 2006;48:695–702.

    Article  PubMed  Google Scholar 

  97. Vieira J, Cukiert A, Liberman B. Evaluation of magnetic resonance imaging criteria for cavernous sinus invasion in patients with pituitary adenomas: logistic regression analysis and correlation with surgical findings. Surg Neurol. 2006;65:130–5.

    Article  PubMed  Google Scholar 

  98. Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space. Neurosurgery. 1993;33:610–8.

    CAS  PubMed  Google Scholar 

  99. Micko A, Wöhrer A, Wolfsberger S, Knosp E. Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification. J Neurosurg. 2015;122:803–11.

    Article  PubMed  Google Scholar 

  100. Maschio M, Mengarelli A, Girmenia C, Vidiri A, Kayal R, Gallo M, et al. Trigeminal neuralgia as unusual isolated symptom of fungal paranasal sinusitis in patients with haematological malignancies. Neurol Sci. 2011;33:647–52.

    Article  PubMed  Google Scholar 

  101. Zinreich S, Kennedy D, Malat J, Curtin H, Epstein J, Huff L, et al. Fungal sinusitis: diagnosis with CT and MR imaging. Radiology. 1988;169:439–44.

    Article  CAS  PubMed  Google Scholar 

  102. Schuknecht B, Sturm V, Huisman T, Landau K. Tolosa-Hunt syndrome: MR imaging features in 15 patients with 20 episodes of painful ophthalmoplegia. Eur J Radiol. 2009;69:445–53.

    Article  CAS  PubMed  Google Scholar 

  103. Yousem D, Atlas S, Grossman R, Sergott R, Savino P, Bosley T. MR imaging of Tolosa-Hunt syndrome. Am J Roentgenol. 1990;154:167–70.

    Article  CAS  Google Scholar 

  104. Hahn C, Nicolle D, Lownie S, Drake C. Giant cavernous carotid aneurysms. J Neuro-Ophthalmol. 2001;20:253–8.

    Google Scholar 

  105. Tsai Y, Chen L, Su C, Lu T, Wu C, Kuo C. Utility of source images of three-dimensional time-of-flight magnetic resonance angiography in the diagnosis of indirect carotid-cavernous sinus fistulas. J Neuro-Ophthalmol. 2004;24:285–9.

    Article  Google Scholar 

  106. Bartiromo F, Cirillo L, Caranci F, Elefante A, D’Amico A, Tortora F, et al. Trigeminal perineural spread of head and neck tumors. Neuroradiol J. 2007;20:116–23.

    Article  CAS  PubMed  Google Scholar 

  107. Maroldi R, Farina D, Borghesi A, Marconi A, Gatti E. Perineural tumor spread. Neuroimaging Clin N Am. 2008;18:413–29.

    Article  PubMed  Google Scholar 

  108. Tashi S, Purohit B, Becker M, Mundada P. The pterygopalatine fossa: imaging anatomy, communications, and pathology revisited. Insights Imaging. 2016;7:589–99.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Russo CP, Smoker WR, Weissman JL. MR appearance of trigeminal and hypoglossal motor denervation. Am J Neuroradiol. 1997;18:1375–83.

    CAS  PubMed  PubMed Central  Google Scholar 

  110. Davis SB, Mathews VP, Williams DW. Masticator muscle enhancement in subacute denervation atrophy. Am J Neuroradiol. 1995;16:1292–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  111. Razek A, King A. MRI and CT of nasopharyngeal carcinoma. Am J Roentgenol. 2012;198:11–8.

    Article  Google Scholar 

  112. Chun M, Eom T, Lim G, Kim J. Secondary trigeminal neuralgia attributed to paranasal sinusitis in a pediatric patient. Child’s Nerv Syst. 2017;33:397–8.

    Article  Google Scholar 

  113. Graff-Radford S, Gordon R, Ganal J, Tetradis S. Trigeminal neuralgia and facial pain imaging. Curr Pain Headache Rep. 2015;19:19.

    Article  PubMed  Google Scholar 

  114. Chang PC, Fischbein NJ, Holliday RA. Central skull base osteomyelitis in patients without otitis externa: imaging findings. Am J Neuroradiol. 2003;24:1310–6.

    PubMed  PubMed Central  Google Scholar 

  115. Chong J, Hinckley LK, Ginsberg LE. Masticator space abnormalities associated with mandibular osteoradionecrosis: MR and CT findings in five patients. Am J Neuroradiol. 2000;21:175–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  116. Hojaili B, Barland P. Trigeminal neuralgia as the first manifestation of mixed connective tissue disorder. JCR J Clin Rheumatol. 2006;12:145–7.

    Article  PubMed  Google Scholar 

  117. Hagen NA, Stevens JC, Michet CJ. Trigeminal sensory neuropathy associated with connective tissue diseases. Neurology. 1990;40:891–6.

    Article  CAS  PubMed  Google Scholar 

  118. Kumar V, Kaur J, Pothuri P, Bandagi S. Atypical trigeminal neuralgia: a rare neurological manifestation of systemic lupus erythematosus. Am J Case Rep. 2017;18:42–5.

    Article  PubMed  PubMed Central  Google Scholar 

  119. Kalanie H, Harandi A, Mardani M, Shahverdi Z, Morakabati A, Alidaei S, et al. Trigeminal neuralgia as the first clinical manifestation of Anti-Hu paraneoplastic syndrome induced by a borderline ovarian mucinous tumor. Case Rep Neurol. 2014;6:7–13.

    Article  PubMed  PubMed Central  Google Scholar 

  120. Cruccu G, Gronseth G, Alksne J, et al. AAN-EFNS guidelines on trigeminal neuralgia management. Eur J Neurol. 2008;15:1013–28.

    Article  CAS  PubMed  Google Scholar 

  121. Gronseth G, Cruccu G, Alksne J, Argoff C, Brainin M, Burchiel K, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008;71:1183–90.

    Article  CAS  PubMed  Google Scholar 

  122. Cruccu G, Truini A. Refractory trigeminal neuralgia. CNS Drugs. 2012;27:91–6.

    Article  Google Scholar 

  123. Gu W, Zhao W. Microvascular decompression for recurrent trigeminal neuralgia. J Clin Neurosci. 2014;21:1549–53.

    Article  PubMed  Google Scholar 

  124. Mousavi S, Akpinar B, Niranjan A, Agarwal V, Cohen J, Flickinger J, et al. The clinical significance of persistent trigeminal nerve contrast enhancement in patients who undergo repeat radiosurgery. J Neurosurg. 2017;127:219–25.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neuroradiology Unit, NESMOS (Neuroscience, Mental Health and Sensory Organs) Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy

    L. Pasquini & A. Bozzao

Authors
  1. L. Pasquini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Bozzao
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiology, Cattinara Hospital, University of Trieste, Trieste, Italy

    Maria Assunta Cova

  2. Department of Radiology, Maggiore Hospital, Trieste, Italy

    Fulvio Stacul

6.1 Electronic Supplementary Material

Cavernous malformation of the pons displayed on T2 FLAIR weighted images. The finding is characterized by etherogeneous signal intensity due to haemorragic transformation in different phases, with hypointense core and hyperintense rim (early/late subacute bleeding) (MOV 4704 kb)

The video displays a diffuse infiltrating pontine glioma showing low-grade features: (a) lack of diffusion restriction on ADC maps (MOV 3581 kb)

The video displays a diffuse infiltrating pontine glioma showing low-grade features: (b) No signal abnormalities on DWI (MOV 10379 kb)

The video displays a diffuse infiltrating pontine glioma showing low-grade features: (c) Hyperintense signal on FLAIR images (MOV 4734 kb)

The video displays a diffuse infiltrating pontine glioma showing low-grade features: (d) No contrast enhancement on post-Gd T1 weighted images (sagittal plane). The cranial portion of the tumor invades the trigeminal nuclei at the level of the pons (MOV 5155 kb)

The video displays a diffuse infiltrating pontine glioma showing low-grade features: (e) No contrast enhancement on post-Gd T1 weighted images (axial plane). The cranial portion of the tumor invades the trigeminal nuclei at the level of the pons (MOV 3626 kb)

The video displays a diffuse infiltrating pontine glioma showing low-grade features: (f) T2 weighted images (MOV 7092 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pasquini, L., Bozzao, A. (2019). Imaging of Trigeminal Neuralgia. In: Cova, M., Stacul, F. (eds) Pain Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-99822-0_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99822-0_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99821-3

  • Online ISBN: 978-3-319-99822-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation