IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Neurovascular compression of trigeminal nerve

Case contributed by Pavan Borra
Diagnosis probable

Presentation

Right cheek pain and numbness for 6 months

Patient Data

Age: 65 years
Gender: Male

A vascular loop of the right superior cerebellar artery is in contact with the medial surface of the proximal cisternal segment of the right trigeminal nerve, and there is apparent thinning deformity of the nerve at this location. The left trigeminal nerve is normal.

Annotated image

Coronal image showing deformity of the right trigeminal nerve by a vascular loop (arrow).

Case Discussion

Based on the clinical findings and involvement of ipsilateral side with no other apparent cause, the diagnosis of trigeminal neuralgia due to vascular compression was suggested.

The patient was treated symptomatically without surgical intervention.

Neurovascular compression syndrome is caused by direct contact with mechanical irritation of cranial nerves by blood vessels.

Not all cases of neurovascular compression are symptomatic. The transitional zone between central and peripheral myelin is the most vulnerable region for symptomatic neurovascular compression. Proximal involvement of the proximal nerve is more likely to be symptomatic with trigeminal neuralgia.

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.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.