Trigeminal pain: Potential role of MRI

Abstract

Objective: The aim of our study was to assess cases of trigeminal pain by MRI to evaluate the underlying pathology and to correlate the imaging findings with the clinical data. Materials and methods: Forty-five patients (28 males and 17 females) with trigeminal pain with or without other associated neurologic symptoms and signs were included in this study. MRI of the brain, dedicated trigeminal view protocol was conducted with contrast injection in the selected cases according to the findings in the conventional scan. Detailed assessment of the course of the trigeminal nerve was conducted (anatomical based assessment). Results: MR could depict the etiology of trigeminal pain in 25 out of 45 patients, 20 patients had idiopathic type trigeminal neuralgia. Eight patients had tumors, 8 patients had vascular anomalies including anatomical variant, vascular loops, and vascular malformations. Five patients had post-trigeminal injury pains. Three patients had demyelination and 1 patient suffered from postherpetic trigeminal neuralgia. The most frequent intracranial portion involved was the cisternal portion followed by the brain stem. Conclusion: MRI study, trigeminal neuralgia protocol can detect the etiology behind patient symptoms.

Keywords

• Trigeminal neuralgia
• MRI
• Vascular loop