Learning objectives
To determine the best MR imaging protocol in the assessment of neurovascular conflict
To provide a systematic approach in order to detect a neurovascular conflict and present the key MR imaging features
Background
Several syndromes involving hyperactivity and abnormal spread of activity within the distribution of innervations of cranial nerves V-IX are now known to be associated,
in several patients,
with vascular compression of the cranial nerve roots.
Redundant arterial loops may cause compression of nerve’s root entry zone (REZ) in the cerebellopontine cistern,
producing hyperactive dysfunction of cranial nerve.
Trigeminal neuralgia,
hemifacial spasm,
glossopharyngeal neuralgia,
some cases of tinnitus and positional vertigo represent the clinical spectrum of long-term compression on V,
VII,
IX,
VIII nerve.
PATHOPHYSIOLGY
Neurovascular...
Imaging findings OR Procedure details
A correct clinical evaluation is fundamental for the Patient’s management: moreover,
the identification of the physiopathological process underlying the condition is of paramount importance because it may lead to the appropriate therapy.
Role of imaging is essential to exclude secondary causes of dysfunction syndrome and can confirm the clinical suspect of NVC.
Currently the NVC imaging relies predominantly on magnetic resonance imaging,
while CT and angiographic techniques maintain an ancillary role in specific issues.
MR IMAGING PROTOCOL
MRI imaging protocol is essentially based on two...
Conclusion
Neurovascular conflict represents a nosological entity that can deeply impact on the life quality of a patient,
up to nearly debilitating forms of chronic and irrepressible pain.
Therefore a correct clinical and diagnostic assessment is fundamental.
Imaging of neurovascular conflict requires a thorough understanding of the neuroanatomy,
neurophysiology and main clinical aspect of cranial nerve dysfunction syndrome.
3D steady state and angiographic MR sequences represent nowadays the most sensitive tools available to radiologists,
allowing an optimal identification of the vascular compression of the cranial nerve’s...
Personal Information
E.
Lozupone,
G.
Di Lella,
S.
Gaudino,
A.
Pedicelli,
R.
Colantonio,
M.
Martucci,
M.
Pileggi,
L.
Bonomo,
C.
Colosimo.
Department of Radiology,
Università cattolica del sacro cuore,
Policlinico “A.
Gemelli”,
Rome,
Italy
E-mail:
[email protected]
References
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Neurology.
Oct 7 2008;71(15):1183-90
Casselman J,
Mermuys K,
Delanote J,
Ghekiere J,
Coenegrachts K. MRI of the cranial nerves - more than meets the eye: technical considerations and...
