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

• Published in: Acta neurochirurgica 2011-12, Vol.153 (12), p.2365-2375
• Main Authors: Guclu, Bulent, Sindou, Marc, Meyronet, David, Streichenberger, Nathalie, Simon, Emile, Mertens, Patrick
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Anatomy; Brain stem; Cadavers; Causality; Compression; Cranial Nerve Diseases - epidemiology; Cranial Nerve Diseases - pathology; Cranial Nerve Diseases - physiopathology; Cranial nerves; Cranial Nerves - cytology; Cranial Nerves - physiology; Cranial Nerves - physiopathology; Experimental Research; Facial nerve; Facial Nerve - pathology; Facial Nerve - physiology; Facial Nerve Diseases - epidemiology; Facial Nerve Diseases - pathology; Facial Nerve Diseases - physiopathology; Female; Glossopharyngeal nerve; Glossopharyngeal Nerve - cytology; Glossopharyngeal Nerve - physiology; Glossopharyngeal Nerve Diseases - epidemiology; Glossopharyngeal Nerve Diseases - pathology; Glossopharyngeal Nerve Diseases - physiopathology; Humans; Interventional Radiology; Male; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Myelin; Nerve Fibers, Myelinated - pathology; Nerve Fibers, Myelinated - physiology; Neuralgia; Neurology; Neuroradiology; Neurosurgery; Radiculopathy - epidemiology; Radiculopathy - pathology; Radiculopathy - physiopathology; Rhombencephalon - cytology; Rhombencephalon - physiology; Rhombencephalon - physiopathology; Skull; Surgical Orthopedics; Syndrome; Trigeminal nerve; Trigeminal Nerve - pathology; Trigeminal Nerve - physiology; Trigeminal Neuralgia - epidemiology; Trigeminal Neuralgia - pathology; Trigeminal Neuralgia - physiopathology; Vagus nerve; Vagus Nerve - pathology; Vagus Nerve - physiology; Vagus Nerve Diseases - epidemiology; Vagus Nerve Diseases - pathology; Vagus Nerve Diseases - physiopathology; Vertebrobasilar Insufficiency - complications; Vertebrobasilar Insufficiency - epidemiology
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-011-1168-1

Objective The aim of this study was to evaluate the anatomy of the central myelin portion and the central myelin-peripheral myelin transitional zone of the trigeminal, facial, glossopharyngeal and vagus nerves from fresh cadavers. The aim was also to investigate the relationship between the length and volume of the central myelin portion of these nerves with the incidences of the corresponding cranial dysfunctional syndromes caused by their compression to provide some more insights for a better understanding of mechanisms. Methods The trigeminal, facial, glossopharyngeal and vagus nerves from six fresh cadavers were examined. The length of these nerves from the brainstem to the foramen that they exit were measured. Longitudinal sections were stained and photographed to make measurements. The diameters of the nerves where they exit/enter from/to brainstem, the diameters where the transitional zone begins, the distances to the most distal part of transitional zone from brainstem and depths of the transitional zones were measured. Most importantly, the volume of the central myelin portion of the nerves was calculated. Correlation between length and volume of the central myelin portion of these nerves and the incidences of the corresponding hyperactive dysfunctional syndromes as reported in the literature were studied. Results The distance of the most distal part of the transitional zone from the brainstem was 4.19 ± 0.81 mm for the trigeminal nerve, 2.86 ± 1.19 mm for the facial nerve, 1.51 ± 0.39 mm for the glossopharyngeal nerve, and 1.63 ± 1.15 mm for the vagus nerve. The volume of central myelin portion was 24.54 ± 9.82 mm 3 in trigeminal nerve; 4.43 ± 2.55 mm 3 in facial nerve; 1.55 ± 1.08 mm 3 in glossopharyngeal nerve; 2.56 ± 1.32 mm 3 in vagus nerve. Correlations ( p