Radiology, Vol 158, 721-727, Copyright © 1986 by Radiological Society of North America
Arterial compression of the fifth cranial nerve causing trigeminal neuralgia: angiographic findings
EE de Lange, GJ Vielvoye and JH Voormolen
A common cause of trigeminal neuralgia (TN) is compression of the root of
the fifth cranial nerve by a tortuous basilar artery or one of its
branches. Microvascular decompression surgery has proved valuable in
relieving the symptoms of these patients with nerve compression. We
performed vertebral angiography on 22 patients with TN. The angiographic
appearances were compared with the findings obtained from an anatomic study
in which the positions of 20 trigeminal nerves in the skull were determined
radiographically in 12 cadavers. By using this information, we were able to
predict the presence of arterial-nerve compression in 20 of the 22
patients, and these positions were later confirmed at surgery. We describe
the angiographic findings in patients with TN as well as the findings in a
control group of 159 individuals with no history of TN. From these
preliminary results, angiography appears to be valuable in the preoperative
evaluation of patients with TN.
