Carson Bateman
Imaging Spectrum of Trigeminal Nerve Pathology
Mentor: Richard Wiggins, MD
Department: Neuroradiology
Background/Purpose:
The trigeminal nerve, with its intricate anatomical course, is prone to a diverse range of pathologies, from benign to malignant. This study aims to delineate the imaging characteristics of common and rare trigeminal nerve pathologies, thereby aiding in accurate diagnosis and management.
Methods:
We reviewed articles mostly consisting of retrospective analyses of imaging studies from patients with confirmed trigeminal nerve pathologies. Both CT and MRI modalities were reviewed, focusing on key imaging features, such as signal intensity, enhancement patterns, and structural involvement. Pathologies examined included nerve sheath tumors, inflammatory conditions, vascular compressions, and malignancies.
Results:
Trigeminal schwannomas demonstrated high T2 signal with heterogeneous enhancement, often originating from the trigeminal cave or cisternal segment. Neurofibromas typically appeared fusiform with less avid enhancement. Inflammatory conditions like multiple sclerosis presented with linear plaques in the intrapontine fascicular part of the nerve. Vascular compression, predominantly by the superior cerebellar artery, was graded based on nerve indentation and displacement. Malignancies, including perineural spread and chondrosarcoma, exhibited distinct imaging features, such as nerve enlargement and low ADC.
Conclusions:
Recognizing the imaging spectrum of trigeminal nerve pathologies is crucial for radiologists to improve diagnostic accuracy. Understanding these features can significantly influence patient management, particularly in distinguishing between benign and malignant conditions and identifying surgical candidates.
