Trigeminal nerve: What the radiologist should know

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

C-1725

Type:

Educational Exhibit

Keywords:

Neuroradiology brain, MR, Education, Pathology

Authors:

H. Nejadhamzeeigilani, T. Buende Tchokouako, J. Macmullen-Price, I. Craven, D. J. Warren, S. Currie; Leeds/UK

DOI:

10.1594/ecr2016/C-1725

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-1725

Fig. 1: Diagram demonstrating V1 course.

Fig. 2: Diagram demonstrating V2 course.

Fig. 3: Diagram demonstrating V3 course.

Fig. 4: T1 sagittal oblique showing right trigeminal nerve emanating from the pons.

Learning objectives

The purpose of this educational exhibit is to: review the normal anatomy of the trigeminal nerve . highlight a variety of pathologies that can effect the trigeminal nerve. signify the importance of a segmental approach to aide identification of the trigeminal nerve and it's pathologies on magnetic resonance (MR) imaging, for the general radiologist.

Background

In this section we will discuss the functional anatomy and important anatomical landmarks that will assist the general radiologist to identify the trigeminal nerve throughout its course. A. FUNCTIONAL ANATOMY (Figure 1-3) The functional relevance of the trigeminal nerve is somatosensory supply to the face, oral and nasal cavities, the teeth and majority of the scalp and motor supply to the masticatory and some other facial muscles. It is also responsible for proprioceptive input from the masticatory and extra-ocular muscles. Figures 1-3 demonstrate the functional...

Findings and procedure details

Pathologies can affect the trigeminal nerve at any level along its course. At its origin the trigeminal nerve may be affected by cerebrovascular disease, inflammatory disease, neoplasia, infection, and vascular malformations. At the level of the pre-pontine cistern pathologies that cause compressive deformity of the nerve dominate, such as tortuous or ectatic vessels and cerebellopontine angle (CPA) neoplasms. Cavernous sinus and basal skull pathologies that affect the trigeminal nerve include aneurysms, neoplasms such as meningioma, schwannoma, lymphoma, and inflammatory disease such as sarcoidosis. In this...

Conclusion

Understanding of the anatomy and function of the trigeminal nerve and combining this with the knowledge of pathological conditions is key to accurate radiological diagnosis at different levels along the course of the nerve.

Personal information

References

Becker M,Kohler R,Vargas MI,Viallon M,Delavelle J.Pathologyof thetrigeminal nerve.Neuroimaging Clin N Am.2008 May;18(2):283-307, x. doi: 10.1016/j.nic.2007.11.002. Bathla G,Hegde AN.Thetrigeminalnerve: anillustratedreviewof itsimaginganatomyandpathology.Clin Radiol.2013 Feb;68(2):203-13. MacNally SP, Rutherford SA, Ramsden RT, Evans DG, King AT. Trigeminal schwannomas. Br J Neurosurg. 2008 Dec;22(6):729-38. Lakshmi M, Glastonbury CM.Imaging of the cerebellopontine angle. Neuroimaging Clin N Am. 2009 Aug;19(3):393-406. Majoie CB, Verbeeten B Jr, Dol JA, Peeters FL. Trigeminal neuropathy: evaluation with MR imaging. Radiographics. 1995 Jul;15(4):795-811