Predictability of vascular conflict by MRI in trigeminal neuralgia

Hitchon, Patrick W.; Bathla, Girish; Moritani, Toshio; Holland, Marshall T.; Noeller, Jennifer; Nourski, Kirill V.

doi:10.1016/j.clineuro.2019.05.005

Cited by 20 publications

(9 citation statements)

References 24 publications

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“…However, the absence of vascular compression on MRI in a patient with classic TN still does not rule out surgery. 20 The limitation of this study is the relatively small number of patients. Therefore, further investigations involving larger patient cohorts are required to extend these results.…”

mentioning

confidence: 94%

Predictability of Fused 3D-T2-SPACE and 3D-TOF-MRA Images in Identifying Conflict in Trigeminal Neuralgia

Pham

Dang

Duong

et al. 2021

JPR

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mentioning

confidence: 94%

Predictability of Fused 3D-T2-SPACE and 3D-TOF-MRA Images in Identifying Conflict in Trigeminal Neuralgia

Pham

Dang

Duong

et al. 2021

JPR

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“…It resulted in a sensitivity of 87%, a specificity of 50%, a positive predictive value of 95% and a negative predictive value of 27%. Specifically, MRI predicted absence of neurovascular contact in 11 patients, while surgery confirmed it in 8 patients (arterial contact in 6 patients and venous contact in 2) [8]. Therefore, even when the advance imaging techniques show no contact between the trigeminal nerve and a vascular structure, surgical exploration could be an option for patients with trigeminal neuralgia.…”

Section: Discussionmentioning

confidence: 99%

Refractory cluster-tic syndrome: The Hickam’s dictum

JA¹,

J²

2021

J Clin Images Med Case Rep

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A 50-year-old man debuted with right trigeminal neuralgia. In the following years, it became refractory to medical treatment and ipsilateral cluster headache appeared. He was diagnosed with cluster-tic syndrome. A brain magnetic resonance with high-spatialresolution 3D T2 sequences (FIESTA) excluded the existence of neurovascular conflict, but a surgical exploration was indicated due to its torpid evolution. A venous contact with the right trigeminal nerve was confirmed in the surgery and microvascular decompression was performed. The patient’s evolution was favorable, improving the trigeminal neuralgia as well as the cluster headache. Keywords: Trigeminal neuralgia; cluster headache; cluster-tic syndrome; microvascular decompression.

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“…Obata et alfound that smaller preoperative cistern deviation index was positively correlated to the recurrence of TN after microvascular decompression (MVD) [ 14 ]. What’s more, Andrei Brînzeu et al [ 28 ] and Patrick W Hitchon et al [ 30 ] found degree of NVC on MR could accurately predict the outcomes of patients with TN who underwent MVD. Coincidentally, Matthew S Willsey et al [ 31 ] pointed out pontine-segment diffusion tensor MR radial diffusivity (RD) could accurately predict the outcomes of TN after MVD.…”

Section: Discussionmentioning

confidence: 99%

Correlation study between multiplanar reconstruction trigeminal nerve angulation and trigeminal neuralgia

Sun

Huang

et al. 2022

BMC Neurol

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Objectives Neurovascular compression (NVC) produces morphological changes on the trigeminal nerve root is considered the cause of trigeminal neuralgia (TN), but there were some patients with TN found no NVC, and also NVC was found in asymptomatic individuals. Many studies found tight relationships of TN and morphological structures of trigeminal nerve. We designed this study to explore the correlation between multiplanar reconstruction (MPR) trigeminal nerve angulation (TNA) and TN. Methods Patients with classical symptoms of TN were recruited as observation group (OG) in this study, 50 healthy controls were enrolled as control group (CG), the OG was further subtyped into young patients (YP), middle-aged patients (MP) and old patients (OP) based to the onset age of symptoms, and also divided into patients with or without trigger maneuvers (TM) based on the presence of TM or not. All the participants underwent magnetic resonance (MR) examinations in same device, bilateral TNA measurements were carried out in OG and CG, then TNA was compared between different groups or subgroups. All images were interpreted by two radiologists who were blinded to the study, diagnosis of TN was made by two senior neurosurgery professors. Result Ultimately, 95 patients with primary TN were recruited in OG, aged from 25 to 84 (61.15 ± 12.70) years with a course of 0.5 to 30 (5.03 ± 5.41) years, their onset age ranged from 24 to 82 (56.13 ± 11.98) years. There were 34 males and 61 females in OG, and 58 cases involved right side. The CG aged from 22 to 85 (61.86 ± 13.03) years. No statistical difference was found between the age of OG and CG(p = 0.76), and also the bilateral TNA of CG (154.92 ± 16.90° vs 155.55 ± 17.03°, p > 0.05), while TNA of OG was significantly smaller than CG (150.78 ± 11.29° vs 155.24 ± 16.88°, p = 0.019). In OG, TNA on the affected side was significantly smaller than the unaffected side (149.29 ± 12.44° vs 152.27 ± 9.85°, p = 0.014). TNA showed a positive correlation with onset age of patients with TN, as TNA on the affected side of YP was significantly smaller than MP and OP (139.00 ± 11.64° vs 148.86 ± 11.54°, 139.00 ± 11.64° vs 152.18 ± 12.61°, p = 0.004 and 0.026). Furthermore, patients with TM showed smaller TNA than those without TM (147.05 ± 11.30° vs 164.75 ± 8.39°, p < 0.001). Conclusions This study suggested that TNA might play a role in TN, small TNA could be a risk factor of TN. Furthermore, patients with small TNA are more likely to combine with TM, but more studies are needed to explore the exact role of TNA in TN.

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Predictability of vascular conflict by MRI in trigeminal neuralgia

Cited by 20 publications

References 24 publications

Predictability of Fused 3D-T2-SPACE and 3D-TOF-MRA Images in Identifying Conflict in Trigeminal Neuralgia

Predictability of Fused 3D-T2-SPACE and 3D-TOF-MRA Images in Identifying Conflict in Trigeminal Neuralgia

Refractory cluster-tic syndrome: The Hickam’s dictum

Correlation study between multiplanar reconstruction trigeminal nerve angulation and trigeminal neuralgia

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