title: The role of the cerebellopontine angle cistern area and trigeminal nerve length in the pathogenesis of trigeminal neuralgia: a prospective case-control study.
abstract: 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.
authors.affiliation: Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. parise@infolink.com.br
authors.forename: Maud
authors.initials: M
authors.lastname: Parise
authors.forename: Marcus André
authors.initials: MA
authors.lastname: Acioly
authors.forename: Carlos Telles
authors.initials: CT
authors.lastname: Ribeiro
authors.forename: Maurice
authors.initials: M
authors.lastname: Vincent
authors.forename: Emerson Leandro
authors.initials: EL
authors.lastname: Gasparetto
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002530:Cerebellopontine Angle / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014276:Trigeminal Nerve / Q000473:pathology* / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000473:pathology* / Q000601:surgery; D055815:Young Adult