Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Acta Neurochir (Wien). 2013 May;155(5):863-8. doi: 10.1007/s00701-012-1573-0. Epub 2012 Dec 7.
The aim of this prospective study was to evaluate whether the cerebellopontine angle (CPA) cistern area and trigeminal nerve cisternal length play a role in the pathogenesis of trigeminal neuralgia (TN).
High-resolution 1.5 T magnetic resonance imaging of the posterior fossa was performed in 26 patients with TN and 18 age-matched healthy controls. Axial T2-weighted, three-dimensional constructive interference in steady-state (3D-CISS) was used to measure bilaterally the cross-sectional area of the CPA cistern and trigeminal nerve cisternal length.
In patients, the cross-sectional area of the CPA cistern and trigeminal nerve cisternal length was smaller on the affected side (p = 0.04). Healthy controls tended to have larger cisternal areas and longer trigeminal nerve lengths than patients (p = 0.059, p = 0.071, respectively). Larger CPA cisternal areas tended to be seen in older patients. There was a strong correlation between the cross-sectional area of the CPA cistern and the length of the trigeminal nerve (p = 0.000).
Smaller CPA cisterns and short cisternal trigeminal nerves impact the pathogenesis of essential TN by facilitating the neurovascular conflict, especially in younger patients. Trigeminal nerve cisternal measurement provides an easy and direct estimation of the CPA area. This information can be used for surgical planning and potentially for outcome prediction.
本前瞻性研究旨在评估小脑脑桥角（CPA）池面积和三叉神经池长度是否在三叉神经痛（TN）发病机制中起作用。
对 26 例 TN 患者和 18 例年龄匹配的健康对照者进行高分辨率 1.5T 磁共振后颅窝成像。采用轴向 T2 加权三维稳态构象干扰（3D-CISS）测量双侧 CPA 池的横截面积和三叉神经池长度。
患者患侧 CPA 池横截面积和三叉神经池长度较小（p=0.04）。健康对照组的池面积大于患者（p=0.059，p=0.071），而三叉神经长度则小于患者（p=0.059，p=0.071）。CPA 池面积较大的患者年龄较大。CPA 池的横截面积与三叉神经的长度之间存在很强的相关性（p=0.000）。
较小的 CPA 池和较短的三叉神经池通过促进神经血管冲突影响原发性 TN 的发病机制，尤其是在年轻患者中。三叉神经池测量为 CPA 区域提供了一种简单直接的估计方法。这些信息可用于手术计划，并可能用于预测结果。
