Novel 3D MR angiographic findings of neurovascular compressive sites in patients with trigeminal neuralgia

Neurovascular compressive sites at the root entry zone of the trigeminal nerve were investigated in 25 patients with trigeminal neuralgia by using the fine three-dimensional (3D) magnetic resonance (MR) angiogram, obtained by a 3D time-of-flight, spoiled gradient-recalled sequence. The characteristic 3D MR angiographic findings of the offending vessels were obtained at the neurovascular compressive sites 19/23 (83%), including intermittent MR signal intensity within the vessels in 14/23 (61 %), and unclear margin of the vessels in 5/23 (22%). Those abnormal 3D MR angiographic findings were commonly observed at the site of neurovascular compression in conjunction with moderate degree (grade II) and severe degree (grade III) in 19/20 (95%) of the actual nerve compression by the offending vessels. Abnormal findings with 3D MR angiograms may provide flow-related information to suggest a certain neurovascular compression upon the trigeminal nerve by the offending vessels. Those novel 3D MR angiographic findings may be useful for the diagnosis and decision-making process to execute the microvascular decompression surgery in patients with trigeminal neuralgia.