RESUMO
BACKGROUND: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Assuntos
Ângulo Cerebelopontino/patologia , Nervo Trigêmeo/patologia , Neuralgia do Trigêmeo/patologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Nervo Trigêmeo/cirurgia , Neuralgia do Trigêmeo/cirurgia , Adulto JovemAssuntos
Ângulo Cerebelopontino/patologia , Imageamento por Ressonância Magnética , Nervo Trigêmeo/patologia , Neuralgia do Trigêmeo/patologia , Ablação por Cateter , Ângulo Cerebelopontino/cirurgia , Descompressão Cirúrgica , Feminino , Humanos , Pessoa de Meia-Idade , Rizotomia , Nervo Trigêmeo/cirurgia , Neuralgia do Trigêmeo/cirurgiaRESUMO
Os autores registram um caso de paraplegia causada por uma lesao granulomatosa de PCM intramedular. O diagnostico clinico neurologico de uma lesao compressiva intramedular foi confirmado pelo exame de ressonancia nuclear magnetica da coluna, que mostrou lesao captante de contraste a nivel de T12. O paciente foi operado e a lesao totalmente retirada. O exame histopatologico da peca operatoria confirmou o diagnostico de PCM. O doente esta em uso de SMZ/TMP e fluconazol com boa recuperacao neurologica
