Radiology of trigeminal neuralgia

CT findings in ninty-nine patients with trigeminal neuralgia were reviewed. Brain tumors including three trigeminal neurinomas, three meningiomas, one epidermoid, one acoustic neurinoma, were found in eight cases as a cause of symptomatic trigeminal neuralgia. Among seventy-nine patients with idiopathic trigeminal neuralgia, four cases had vascular decompression surgery because of the tortuous, ectatic or anomalous vertebrobasilar artery. Among the other seventy-five non-surgical cases, seventeen cases showed the tortuous and/or ectatic vertebrobasilar artery on CT, and this group of patients showed slightly higher recurrence rate of trigeminal neuralgia after nerve block or medication compared with other non-surgical patients. CT is thought to be a useful screening imaging modality for evaluation of patients with trigeminal neuralgia, and angiography is required for precise evaluation of the compressing vessels when surgical treatment is contemplated. (author)