Nerve atrophy and a small trigeminal pontine angle in primary trigeminal neuralgia: A morphometric MRI study

Abstract Objective To prospectively evaluate the morphological and structural changes of trigeminal nerve in patients with trigeminal neuralgia (TN) and to perform a comparison with healthy controls. Methods We conducted a prospective case-control study of 60 consective patients diagnosed with TN an...

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Bibliographic Details
Published in:World neurosurgery 2017
Main Authors: Cheng, Jian, M.D, Meng, Jinli, M.D, Liu, Wenke, M.D, Zhang, Heng, M.D, Lei, Ding, M.D, Hui, Xuhui, M.D
Format: Article
Language:English
Subjects:
Neurosurgery
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Summary:Abstract Objective To prospectively evaluate the morphological and structural changes of trigeminal nerve in patients with trigeminal neuralgia (TN) and to perform a comparison with healthy controls. Methods We conducted a prospective case-control study of 60 consective patients diagnosed with TN and 30 sex-and age-matched healthy controls. All subjects underwent high-resolution three-dimensional MRI. The volume and length of the cisternal segment of trigeminal nerve and the angle between the trigeminal nerve and the anterior surface of the pons (trigeminal pontine angle) were measured and compared. Results The mean volume of the affected trigeminal nerve was significantly reduced in comparison to that of the nonaffected side (65.8±21.1 versus 77.9±19.3 mm3, P=0.001) and controls (65.8±21.1 versus 74.7±16.5, P=0.003). The mean trigeminal pontine angle was 42.4±8.7 degrees on the affected side, 47.6±9.2 degrees on the nonaffected side, and 46.0±7.2 degrees in the control group. The affected side trigeminal pontine angle was significantly smaller in comparison to that of the nonaffected side (P=0.005) and control group (P=0.01). There was no statistically significant difference in the mean length of the cisternal segment of trigeminal nerve between the affected and nonaffected sides (P = 0.46). Conclusions TN is associated with atrophy and a small trigeminal pontine angle on the affected nerve. Nerve atrophy may be a late consequence of chronic physical stress and is probably involved in the pathogenesis of TN. A small trigeminal pontine angle may increase the chance of neurovascular conflict, and thus more likely to result in the genesis of TN.
ISSN:1878-8750
DOI:10.1016/j.wneu.2017.05.057