Magnetic Resonance Imaging Assessment of Vascular Contact of the Facial Nerve in the Asymptomatic Patient

Deep, Nicholas L.; Fletcher, Geoffrey P.; Nelson, Kent D.; Patel, Ajay Kumar; Barrs, David M.; Bendok, Bernard R.; Hoxworth, Joseph M.

doi:10.1055/s-0036-1584196

Cited by 15 publications

(6 citation statements)

References 30 publications

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“…A 17% rate of compression of the trigeminal nerve by the SCA has been reported in asymptomatic patients [ 6 ]. Similarly, it has been estimated that vascular compression of CN VII occurs in as many as 53% of asymptomatic patients [ 13 ]. McDermott, et al classified vascular loops of the AICA into three subtypes: Type I, in which an AICA loop occurs within the CP angles; type II, where the AICA loop enters less than half the length of the IAC; and type III, where the AICA enters more than half the length of the IAC [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex

Alonso

Kassem

Iwanaga

et al. 2017

Cureus

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Vascular loops in the cerebellopontine angle (CPA) and their relationship to cranial nerves have been used to explain neurological symptoms. The anterior inferior cerebellar artery (AICA) has variable branches producing vascular loops that can compress the facial cranial nerve (CN) VII and vestibulocochlear (CN VIII) nerves. AICA compression of the facial-vestibulocochlear nerve complex can lead to various clinical presentations, including hemifacial spasm (HFS), tinnitus, and hemiataxia. The formation of arterial loops inside or outside of the internal auditory meatus (IAM) can cause abutment or compression of CN VII and CN VIII.Twenty-five (50 sides) fresh adult cadavers underwent dissection of the cerebellopontine angle in the supine position. In regard to relationships between the AICA and the nerves of the facial/vestibulocochlear complex, 33 arteries (66%) traveled in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Five arteries (10%) traveled below the CN VII/VIII complex, six (12%) traveled posterior to the nerve complex, four (8%) formed a semi-circle around the upper half of the nerve complex, and two (4%) traveled between and partially separated the nervus intermedius and facial nerve proper. Our study found that the majority of AICA will travel in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Although the relationship between the AICA and porus acusticus and AICA and the nerves of the CN VII/VIII complex are variable, based on our findings, some themes exist. Surgeons should consider these with approaches to the cerebellopontine angle.

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Section: Discussionmentioning

confidence: 99%

Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex

Alonso

Kassem

Iwanaga

et al. 2017

Cureus

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“…However, it is crucial to note that the diagnosis of HFS still primarily relies on clinical assessment, including the detection of lateral spread of electromyography potentials. Additionally, in clinical practice, NVC events can be observed in the MRI of healthy individuals (Deep et al., 2016 ). This emphasizes the importance for radiologists, when confronted with NVC events or patients with HFS, to conduct a comprehensive assessment integrating clinical manifestations.…”

Section: Discussionmentioning

confidence: 99%

Evaluating magnetic resonance imaging characteristics and risk factors for hemifacial spasm

Li,

Luo,

Jin

et al. 2024

Brain and Behavior

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PurposeThe specific neurovascular compression (NVC) event responsible for the symptomatic manifestation of hemifacial spasm (HFS) remains difficult to assess accurately using magnetic resonance imaging (MRI). We aim to evaluate the MRI characteristics of HFS.MethodWe retrospectively included patients with HFS and divided them into a test group (n = 186) and a validation group (n = 28). The presence, severity, and offending vessel type of NVC in each portion, and the orientation of the offending vessel around the facial nerve, were recorded. Conditional logistic regression analyses were performed to evaluate correlations using test group. The validation group was used to verify whether our findings improved diagnostic performance.ResultsDeformity in the proximal cisternal segment was significantly correlated with HFS occurrence (odds ratio [OR]: 256.58, p = .002), whereas contact was not (p = .233). Both contact and deformity in the root detachment point (OR: 19.98 and 37.22, p < .001 and p = .013, respectively) or attached segment (OR: 4.99 and 252.52, p = .001 and p < .001, respectively) were significantly correlated with HFS occurrence. Our findings improved specificity, positive predictive value, and accuracy of diagnosis than conventional diagnostic methods. The vertebral artery predominantly compress the facial nerve in the inferior‐anterior position, the anterior inferior cerebellar artery predominantly in the inferior position, the posterior inferior cerebellar artery predominantly in the inferior position, vein predominantly in the posterior–superior position.ConclusionsThis study further demonstrates that within the susceptible portion of facial nerve, different portions of the nerve respond differently to NVC. Each offending vessel has its own preferred conflict orientation. Our study offers reference for neurosurgeons in diagnosis and treatment.

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“…A recent study by Jani et al identified neurovascular compression in 18 out of 27 patients on T2-weighted FIESTA thin-cut sequence performed with a 3 T scanner ( 25 ). However, Deep et al reported up to 53% NCV in asymptomatic patients using high-resolution MRI on 200 examined nerves ( 26 ). Different pathophysiological theories such as bioresonance hypothesis and ignition hypothesis have been developed to explain the TN pathogenesis ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

The role of artificial intelligence in the management of trigeminal neuralgia

Battistelli,

Izzo,

D’Ercole

et al. 2023

Front. Surg.

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Trigeminal neuralgia (TN) is the most frequent facial pain. It is difficult to treat pharmacologically and a significant amount of patients can become drug-resistant requiring surgical intervention. From an etiologically point of view TN can be distinguished in a classic form, usually due to a neurovascular conflict, a secondary form (for example related to multiple sclerosis or a cerebello-pontine angle tumor) and an idiopathic form in which no anatomical cause is identifiable. Despite numerous efforts to treat TN, many patients experience recurrence after multiple operations. This fact reflects our incomplete understanding of TN pathogenesis. Artificial intelligence (AI) uses computer technology to develop systems for extension of human intelligence. In the last few years, it has been a widespread of AI in different areas of medicine to implement diagnostic accuracy, treatment selection and even drug production. The aim of this mini-review is to provide an up to date of the state-of-art of AI applications in TN diagnosis and management.

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Magnetic Resonance Imaging Assessment of Vascular Contact of the Facial Nerve in the Asymptomatic Patient

Cited by 15 publications

References 30 publications

Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex

Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex

Evaluating magnetic resonance imaging characteristics and risk factors for hemifacial spasm

The role of artificial intelligence in the management of trigeminal neuralgia

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