Radiological anatomy of the transcranial segment of the trigeminal nerve

QIAO Ming-liangDIAO Yu-ling LIANG Liang ZHANG Meng-nan ZHANG Ming*GAO Yan*

Acta Anatomica Sinica ›› 2015, Vol. 46 ›› Issue (1) : 85-90.

Welcome to visit Acta Anatomica Sinica! Today is Chinese
Acta Anatomica Sinica ›› 2015, Vol. 46 ›› Issue (1) : 85-90. DOI: 10.16098/j.issn.0529-1356.2015.01.015

Radiological anatomy of the transcranial segment of the trigeminal nerve

  • QIAO Ming-liang 1,2DIAO Yu-ling1 LIANG Liang1 ZHANG Meng-nan1 ZHANG Ming 3*GAO Yan 1*
Author information +
History +

Abstract

Objective To reveal radiological anatomy of the transcranial segment of the trigeminal nerve and its surrounding structures. Methods A total of 26 adult cadaveric heads (10 female, 16 male, aged 45~81 years, mean 63.8 years) were examined with microdissection, micro-computed tomography (micro-CT) and epoxy sheet plastination methods. Observation from the cadaveric study was compared with Bone window CT images (32) and B-FFE sequence MRI images (3)from 35 living subjects. Results The ophthalmic division of the trigeminal nerve and the oculomotor, trochlear and abducent nerves were surrounded by the dura and arachnoid mater, traversed supraorbital fissure together and formed a physiological narrowing. The application of CT combined with MRI revealed the narrowing. Foramen rotundum appeared asacurved bony pipeline with a bony protrusion in the middle of the medial wall. The maxillary division of the trigeminal nerve was close to the bony protrusion, which was demonstrated better in CT than in MRI. Both the mandibular division of the trigeminal nerve and venous plexus passed through the foramen ovale. At this site, the application of MRI was superior to CT. Conclusion There are three likely mechanical compression points along the course of the trigeminal nerve in the skull base. CT or MRI or a combination of the both may be able to localize these points and provide the needs for the clinical diagnosis.

Key words

Skull base / Trigeminal nerve / Sheet plastination / Microdissection / Radiological Anatomy / Adult

Cite this article

Download Citations
QIAO Ming-liangDIAO Yu-ling LIANG Liang ZHANG Meng-nan ZHANG Ming*GAO Yan*. Radiological anatomy of the transcranial segment of the trigeminal nerve[J]. Acta Anatomica Sinica. 2015, 46(1): 85-90 https://doi.org/10.16098/j.issn.0529-1356.2015.01.015

References

[1]Xu HJ, Wu YM, Li ChF. Microsurgical relationships of the arteries at the base of the brain and the trigeminal nerve[J]. Acta Anatomica Sinica, 1982, 13(3):249-254. (in Chinese)徐慧君,武义鸣,李传夫. 脑底动脉与三叉神经关系的显微外科解剖[J]. 解剖学报, 1982, 13(3):249-254.
[2]Neto HS, Camilli JA, Marques MJ. Trigeminal neuralgia iscaused by maxillary and mandibular nerve entrapment: greater incidence of right-sided facial symptoms is due to the foramen rotundum and foramen ovale being narrower on the right side of the cranium[J]. Med Hypotheses, 2005, 65(6):1179-1182.
[3]Nurmikko T, Miles J, Eldridge P, et al. Treatment for trigeminal neuralgia.Pathophysiological mechanisms of trigeminal neuralgia need to be explored[J]. BMJ, 1997, 314(7079):519.
[4]Scrivani SJ, Mathews ES, Maciewicz RJ.Trigeminal neuralgia[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2005,100(5):527-538.
[5]Toda K. Etiology of trigeminal neuralgia[J]. Oral Sci Int, 2007, 4:10-18.
[6]Wen HB,Yuan XR. Status and progress of surgical treatment of trigeminal neuralgia[J]. Foreign Medical Science Section on Neurology Neurosurgery,  2002, 29(6):550-553.(in Chinese)
文红波,袁贤瑞. 三叉神经痛手术治疗现状及进展[J]. 国外医学神经病学神经外科学分册, 2002, 29(6):550-553.
[7]Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis[J]. Brain,2001, 124(Pt12):2347-2360.
[8]Nurmikko TJ, Eldridge PR. Trigeminal neuralgia-pathophysiology, diagnosis and current treatment[J]. Br J Anaesth,2001,87(1):117-132.
[9]Eboli P, Stone JL, Aydin S, et al. Historical characterization of trigeminal neuralgia[J]. Neurosurgery, 2009, 64(6):1183-1186.
[10]Baechli H, Gratzl O. Microvascular decompression in trigeminal neuralgia with no vascular compression[J]. Eur Surg Res, 2007, 39(1):51-57.
[11]Revuelta-Gutierrez R, Lopez-Gonzalez MA, Soto-Hernandez JL. Surgical treatment of trigeminal neuralgia without vascular compression: 20 years of experience[J]. Surg Neurol,2006,66(1):32-36.
[12]Adamczyk M, Bulski T, Sowinska J, et al.Trigeminal nerve—artery contact in people without trigeminal neuralgia-MR study[J]. Med Sci Monit, 2007, 13(Suppl 1):38-43.
[13]Kakizawa Y, Seguchi T, Kodama K, et al. Anatomical study of the trigeminal and facial cranial nerves with the aid of 3.0-tesla magnetic resonance imaging[J]. J Neurosurg, 2008, 108(3):483-490. 
[14]Peker S, Dincer A, Necmettin Pamir M. Vascular compression of the trigeminal nerve is a frequent finding in asymptomatic individuals: 3-T MR imaging of 200 trigeminal nerves using 3DCISS sequences[J]. Acta Neurochir (Wien), 2009,151(9):1081-1088.
[15]Liang L, Diao YL, Xu QY, et al.Transcranial segment of the trigeminal nerve:macro-/microscopic anatomical study using sheet plastination[J]. Acta Neurochir (Wien), 2014,156(3):605-612. 
[16]Liu M,Chen ShG,Zhang M. Asymmetry of the human cricothyroid joint[J]. Acta Anatomica Sinica, 2013,44(1):85-88. (in Chinese)
刘明, 陈胜国, 张铭. 环甲关节的不对称性[J]. 解剖学报, 2013, 44(1) :85-88.
[17]Zhou B,Liu YG,Wu ChY. Rat animal model of trigeminal neuralgia[J]. Shandong Medical Journal,  2005, 45(3):21-23. (in Chinese)
周瑸,刘玉光,吴承远. 建立大鼠三叉神经痛动物模型[J]. 山东医药,  2005, 45(3):21-23. 
[18]Pang G, Han H, Hu YT, et al.  Sheet frontal sectional anatomy of superior orbital fissure region and its passing structures[J]. Chinese Journal of Anatomy 2006, 29(4):490-494. (in Chinese)
庞刚,韩卉,胡玉婷, 等. 眶上裂区及其穿经结构的薄层冠状断层解剖学[J]. 解剖学杂志, 2006,29(4):490-494.
[19]Renn WH, Rhoton AL Jr.  Microsurgical anatomy of the sellar region[J]. J Neurosurg, 1975,43(3):288-298.
[20]Rhoton AL Jr. The sellar region[J]. Neurosurgery, 2002, 51(4 Suppl):S335-S374. 
[21]Rhoton AL Jr, Hardy DG, Chambers SM. Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region[J]. Surg Neurol, 1979, 12(1):63-104.
[22]Rhoton AL Jr, Harris FS, Renn WH. Microsurgical anatomy of the sellar region and cavernous sinus[J]. Clin Neurosurg, 1977, 24:54-85.
[23]Zada G, Agarwalla PK, Mukundan S Jr, et al. The neurosurgical anatomy of the sphenoid sinus and sellar floor in endoscopic transsphenoidal surgery[J]. J Neurosurg, 2011,114(5):1319-1330.
[24]Zhou LX,Ma ShJ,Zheng LM. Preliminary study of Dynamic 3D C E-MRV in the diagnosis and treatment of intracranial diseases[J]. Radiol Practice, 2010, 25(11):1216-1219. (in Chinese)
周立霞, 马淑杰, 郑历明. 动态3D CE-MRV在颅内疾病诊断及治疗中的应用初探[J]. 放射学实践,2010,25(11):1216-1219.

Funding

Minimally-invasive surgical anatomy of the lateral part of the middle cranial fossa

Accesses

Citation

Detail

Sections
Recommended

/