Abarca-Olivas Javier, Feliu-Rey Eloísa, Sempere Angel P, Sanchez-Payá José, Baño-Ruiz Elena, Caminero-Canas Miguel Angel, Nieto-Navarro Juan, Botella-Asunción Carlos
Secretaría de Neurocirugía, Hospital General Universitario de Alicante, Pintor Baeza s/n, Alicante, Spain.
Rev Neurol. 2010 Nov 1;51(9):520-4.
The neurovascular conflict is now considered an unquestionable dogma in the pathophysiology of idiopathic trigeminal neuralgia (ITN). However, there are more and more papers that provide information about other factors that promote such conflict or neuralgia itself. AIMS. To measure the volume of the substructures of the posterior fossa in patients with ITN and controls and to investigate the association between a reduced volume of these structures and the incidence of ITN.
In 20 patients with unilateral ITN and 20 healthy participants, high resolution 1.5 T magnetic resonance imaging scans including axial and coronal sequences T2-weighted with a slice thickness of 1 mm were performed with the aim of a volumetric study of pontomesencephalic cistern, Meckel's cave and trigeminal nerve.
Measuring the pontomesencephalic cistern on each side of the midline, the volume of the affected side cistern was significantly lower than the healthy side one in patients with ITN (p = 0.004) and also when compared with controls hemicisterns. No significant differences in the Meckel's cave nor the trigeminal nerve were found. The incidence of neurovascular conflict was also studied resulting in 10% of patients with ITN where the conflict was not identified.
Our data support the theory that a small volume of the posterior fossa cisterns containing the trigeminal nerve may increase the incidence of ITN.
神经血管冲突现在被认为是特发性三叉神经痛（ITN）病理生理学中无可争议的教条。然而，越来越多的论文提供了关于促进这种冲突或神经痛本身的其他因素的信息。目的：测量ITN患者和对照组后颅窝亚结构的体积，并研究这些结构体积减小与ITN发病率之间的关联。
对20例单侧ITN患者和20名健康参与者进行了高分辨率1.5T磁共振成像扫描，包括轴向和冠状序列的T2加权像，层厚1mm，目的是对脑桥小脑池、Meckel腔和三叉神经进行体积研究。
测量中线两侧的脑桥小脑池，ITN患者患侧脑池的体积明显低于健侧（p = 0.004），与对照组的半侧脑池相比也是如此。在Meckel腔和三叉神经方面未发现显著差异。还研究了神经血管冲突的发生率，结果发现10%的ITN患者未发现冲突。
我们的数据支持这样一种理论，即包含三叉神经的后颅窝脑池体积较小可能会增加ITN的发病率。
