Glossopharyngeal neuralgia due to vascular compression

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Right throat and tongue pain. Likely due to Eagle's syndrome. MRI skull base to exclude glossopharyngeal nerve abnormality.

Patient Data

Age: 55 years
Gender: Male

The root entry zone of the right glossopharyngeal nerve (CN IX) is posteriorly displaced and distorted compared to the left (best seen on axial FIESTA). This is due to vascular compression by the right posterior inferior cerebellar artery (PICA) which is seen well on the axial T2 FS images (flow void) and also on the TOF angiogram.    

The root entry zone of the right glossopharyngeal nerve (CN IX) is posteriorly displaced and distorted compared to the left (yellow arrows) due to vascular compression by the right posterior inferior cerebellar artery (red arrow).    

Case Discussion

A case of right glossopharyngeal neuralgia due to vascular compression of the root entry zone by the posterior inferior cerebellar artery (PICA). This patient went on to have surgical microvascular decompression with complete resolution of his symptoms.    

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.