The trigeminal nerve is divided into four segments: brainstem, cistern, Meckel cave/ cavernous sinus and extracranial segments.
The common cause of trigeminal neuralgia are 1:
- brain stem segment - multiple sclerosis, infarct and glioma
- cisternal segment - neurovascular compression, acoustic and trigeminal schwannomas, meningiomas, epidermoid cysts, lipomas and metastases
- Meckel cave and cavernous sinus - meningiomas, trigeminal schwannomas, epidermoid cysts, metastases, pituitary adenoma and aneurysm.
- extracranial - perineural tumor spread
Tortuous, elongated superior cerebellar artery (common), elongated anterior inferior cerebellar artery, vertebrobasilar dolichoectasisa or venous compression are the causes of neurovascular compression in the cisternal segment of trigeminal nerve 1.