Figure 3 - uploaded by Imtiaz Ali Panhwar
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a & b: T2W sagittal and axial FIESTA images show only tiny vessel touching the superior surface of cisternal segment of right trigeminal nerve.
Source publication
Trigeminal neuralgia is a very painful condition in the sensory distribution of the trigeminal nerve and most common cause is compression of the cisternal segment of the trigeminal nerve by a vessel, usually an artery. However a number of additional pathologies may affect the trigeminal nerve anywhere along its course from origin to the most periph...
Similar publications
Trigeminal neuralgia (TN) is a debilitating yet potentially treatable facial pain disorder.TN is difficult to miss clinically, as patients' clinical presentation is often strikingly stereotypical: unilateral, paroxysmal, stimulus-dependent pain involving the trigeminal territory. Magnetic resonance imaging (MRI), which is used for further evaluatio...
Citations
... An absent Meckel's cave as a possible cause of TN is a rarely described and poorly understood entity. Such a phenomenon has been described in only 2 case series, 7 patients and 3 patients, respectively, and 2 case reports, adding up to a total of 12 cases [10][11][12][13] . Interestingly, all cases reported in the literature, including ours, were female. ...
Trigeminal neuralgia (TN) is a debilitating yet potentially treatable facial pain disorder.TN is difficult to miss clinically, as patients' clinical presentation is often strikingly stereotypical: unilateral, paroxysmal, stimulus-dependent pain involving the trigeminal territory. Magnetic resonance imaging (MRI), which is used for further evaluation of an underlying eti-ology of TN, most commonly shows neurovascular compression of the trigeminal nerve to be the culprit. Secondary etiologies, though less common, do exist. An absent Meckel's cave with ipsilateral TN was reported in a few case reports and series, and whether an etiological relationship exists is yet to be established. We herein present a case of a 22-year-old female patient who presented with typical TN clinical manifestations. MRI was ordered to assess for the underlying cause and an ipsilateral absent Meckel's cave was the only significant finding. This case report adds to the scarcity of literature highlighting this entity, further larger clinical studies are needed to establish a causal relationship.
... A rarely reported entity, absence of Meckel cave, has been described in a few patients with TN, including 2 case reports and 3 patient case series. [4][5][6] Most important, there are only a few reports, to our knowledge, on the absence of Meckel cave in patients other than those with TN. This retrospective study aimed to demonstrate the potential relationship of an absent Meckel cave with TN versus without TN, which may have important diagnostic and treatment implications. ...
Trigeminal neuralgia is a debilitating condition with numerous etiologies. In this retrospective case series, we report a cohort of patients with a rarely described entity, absence of Meckel cave, and propose this as a rare cause of trigeminal neuralgia. A search of the electronic medical record was performed between 2000 and 2020 to identify MR imaging reports with terms including "Meckel's cave" and "hypoplasia," "atresia," "collapse," or "asymmetry." Images were reviewed by 2 blinded, board-certified neuroradiologists. Seven cases of the absence of Meckel cave were identified. Seven patients (100%) had ipsilateral trigeminal neuralgia and ipsilateral trigeminal nerve atrophy, suggesting an association between absence of Meckel cave and trigeminal neuralgia. Absence of Meckel cave is a rare entity of unknown etiology, with few existing reports that suggest the possibility of an association with trigeminal neuralgia. Its recognition may have important implications in patient management. Future studies and longitudinal data are needed to assess treatment outcomes and added risks from surgical intervention in these patients.
Trigeminal neuralgia (TN) is a disabling painful condition along the course of the sensory distribution of the trigeminal nerve that most commonly occurs due to vascular compression or conflict at the root entry zone of the trigeminal nerve. We report a 27-year-old female patient who presented with pain and an electric shock-like sensation on the right side of her face that started three years ago. Magnetic resonance imaging of the brain was done and revealed no neurovascular conflict along the course of the trigeminal nerve. The absence of Meckel's cave with atrophy of the cisternal segment of the trigeminal nerve on the affected side was reported. The absence of Meckel's cave is an exceedingly rare cause of TN, and only a handful of reported cases in the literature suggest the association between them.
