Diagnostik neurovaskulärer Kompressionssyndrome

S. Langner; H. W. Schroeder; N. Hosten; M. Kirsch

doi:10.1055/s-0031-1281976

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2012; 184(3): 220-228
DOI: 10.1055/s-0031-1281976

Neuroradiologie

Diagnostik neurovaskulärer Kompressionssyndrome

Diagnosing Neurovascular Compression Syndromes

S. Langner

²Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald

,

H. W. Schroeder

¹Klinik und Poliklinik für Neurochirurgie der Ernst- Moritz-Arndt-Universität, Universitätsmedizin Greifswald

,

N. Hosten

²Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald

,

M. Kirsch

²Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald

› Author Affiliations

Abstract

Zusammenfassung

Hintergrund: Neurovaskuläre Kompressionssyndrome sind Krankheitsbilder, welche durch die Affektion eines Hirnnerven im Bereich seiner „root exit/entry zone“ durch eine Gefäßschlinge bedingt sind und paroxysmale motorische oder sensorische Sensationen im betroffenen Nerven auslösen können.

Material und Methode: Übersichtsarbeit auf der Basis einer selektiven Literaturaufarbeitung.

Ergebnisse: Diese Krankheitsbilder sind etabliert für die Trigeminusneuralgie, den Hemispasmus facialis, die Vestibularisparoxysmie sowie die Glossopharyngeusneuralgie. Hirnnervenausfälle durch die Kompression durch ein Aneurysma, z. B. N. oculomotorius-Parese bei einem Aneurysma des Ramus communicans posterior, zählen jedoch ebenso zu den neurovaskulären Kompressionssyndromen. Verschiedene neurovaskuläre Kompressionssyndrome werden vorgestellt, die zur Verfügung stehenden diagnostischen Verfahren sowie die bildmorphologischen Korrelate der einzelnen Krankheitsbilder und posttherapeutische Veränderungen beschrieben.

Schlussfolgerung: Neurovaskuläre Kompressionssyndrome sind Krankheitsbilder, bei deren Diagnostik die MR-Bildgebung eine entscheidende Rolle spielt.

Abstract

Purpose: Neurovascular compression syndromes are diseases caused by abnormal contact between a vessel loop and the root exit/entry zone of a cranial nerve. Compression can cause paroxysmal attacks of abnormal motor or sensory phenomena in the affected nerve.

Materials and Methods: Review based on a selective analysis of the literature.

Results: Neurovascular compression syndromes include well-established entities such as trigeminal neuralgia, facial hemispasm, vestibular paroxysmia and glossopharyngeus neuralgia but also cranial nerve disorders caused by compression due to an aneurysm, e. g., oculomotor nerve paresis caused by an aneurysm of the posterior communicating branch. An overview of neurovascular compression syndromes is given, outlining diagnostic procedures and the morphological imaging features of each syndrome as well as the changes seen after treatment are described.

Conclusion: Neurovascular compression syndromes are complex diseases. MR imaging plays an important role in the diagnostic workup of these diseases.

Key words

brain - blood vessels - CNS - CT - MR imaging

Full Text

References

Literatur
1 Dandy WE. Concerning the cause of trigeminal neuralgia. Am J Surg 1934; 24: 447-455
2 Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. Journal of neurosurgery 1967; 26: 159-162
3 Jannetta PJ. Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia 1977; 20: 145-154 [Research Support, U. S. Gov't, Non-P. H. S. Hinweis: im Folgenden gelöscht]
4 Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain 2001; 124: 2347-2360 [Review]
5 Moller AR. The cranial nerve vascular compression syndrome: II. A review of pathophysiology. Acta Neurochir 1991; 113: 24-30 [Review]
6 Nielsen VK. Pathophysiology of hemifacial spasm: I. Ephaptic transmission and ectopic excitation. Neurology 1984; 34: 418-426
7 Adams CB. Microvascular compression: an alternative view and hypothesis. J Neurosurg 1989; 70: 1-12
8 Moller AR. The cranial nerve vascular compression syndrome: I. A review of treatment. Acta Neurochir 1991; 113: 18-23 [Review]
9 Ferguson JH. Hemifacial spasm and the facial nucleus. Ann Neurol 1978; 4: 97-103
10 Fromm GH, Chattha AS, Terrence CF et al. Role of inhibitory mechanisms in trigeminal neuralgia. Neurology 1981; 31: 683-687
11 Cohen-Gadol AA. Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: Naunces of the technique based on experiences with 100 patients and review of the literature. Clin Neurol Neurosurg 2011; 113: 844-853
12 Kress B, Schindler M, Rasche D et al. [Trigeminal neuralgia: how often are trigeminal nerve-vessel contacts found by MRI in normal volunteers]. Fortschr Röntgenstr 2006; 178: 313-315
13 Sindou M, Leston J, Howeidy T et al. Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients. Acta Neurochir 2006; 148: 1235-1245, discussion 45 [Evaluation Studies]
14 Sindou M, Leston J, Decullier E et al. Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. Journal of neurosurgery 2007; 107: 1144-1153
15 Bruyn GW. Glossopharyngeal neuralgia. Cephalalgia: an international journal of headache 1983; 3: 143-157 [Review]
16 Jannetta PJ. Neurovascular compression in cranial nerve and systemic disease. Ann Surg 1980; 192: 518-525
17 Warren HG, Kotsenas AL, Czervionke LF. Trigeminal and concurrent glossopharyngeal neuralgia secondary to lateral medullary infarction. Am J Neuroradiol 2006; 27: 705-707 [Case Reports]
18 Siccoli MM, Bassetti CL, Sandor PS. Facial pain: clinical differential diagnosis. Lancet Neurol 2006; 5: 257-267 [Review]
19 Ito M, Sonokawa T, Mishina H et al. Dural arteriovenous malformation manifesting as tic douloureux. Surg Neurol 1996; 45: 370-375
20 Cruccu G, Biasiotta A, Di Rezze S et al. Trigeminal neuralgia and pain related to multiple sclerosis. Pain 2009; 143: 186-191
21 Borges A, Casselman J. Imaging the trigeminal nerve. Eur J Radiol 2010; 74: 323-340 [Review]
22 Yousry I, Moriggl B, Dieterich M et al. MR anatomy of the proximal cisternal segment of the trochlear nerve: neurovascular relationships and landmarks. Radiology 2002; 223: 31-38
23 Kress B, Rasche D, Fiebach J et al. [MR volumetry of the trigeminal nerve in patients with unilateral facial pain]. Fortschr Röntgenstr 2004; 176: 719-723 [Comparative Study]
24 Lutz J, Linn J, Mehrkens JH et al. Trigeminal neuralgia due to neurovascular compression: high-spatial-resolution diffusion-tensor imaging reveals microstructural neural changes. Radiology 2011; 258: 524-530
25 Yoshino N, Akimoto H, Yamada I et al. Trigeminal neuralgia: evaluation of neuralgic manifestation and site of neurovascular compression with 3D CISS MR imaging and MR angiography. Radiology 2003; 228: 539-545 [Comparative Study]
26 Akimoto H, Nagaoka T, Nariai T et al. Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging. Neurosurgery 2002; 51: 956-961, discussion 61-62 [Case Reports]
27 Leal PR, Hermier M, Souza MA et al. Visualization of Vascular Compression of the Trigeminal Nerve With High-Resolution 3T MRI: A Prospective Study Comparing Preoperative Imaging Analysis to Surgical Findings in 40 Consecutive Patients Who Underwent Microvascular Decompression for Trigeminal Neuralgia. Neurosurgery 2011; 69: 15-26
28 Rughani AI, Dumont TM, Lin CT et al. Safety of microvascular decompression for trigeminal neuralgia in the elderly. Journal of neurosurgery 2011; 115: 202-209
29 Zakrzewska JM. Diagnosis and differential diagnosis of trigeminal neuralgia. Clin J Pain 2002; 18: 14-21 [Review]
30 Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. Journal of neurosurgery 2007; 107: 216-219 [Biography Classical Article Historical Article]
31 Yousry I, Moriggl B, Holtmannspoetter M et al. Detailed anatomy of the motor and sensory roots of the trigeminal nerve and their neurovascular relationships: a magnetic resonance imaging study. Journal of neurosurgery 2004; 101: 427-434
32 Leal PR, Hermier M, Froment JC et al. Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Acta Neurochir 2010; 152: 817-825
33 Satoh T, Omi M, Nabeshima M et al. Severity analysis of neurovascular contact in patients with trigeminal neuralgia: assessment with the inner view of the 3D MR cisternogram and angiogram fusion imaging. Am J Neuroradiol 2009; 30: 603-607 [Case Reports Controlled Clinical Trial]
34 Park SH, Hwang SK, Lee SH et al. Nerve atrophy and a small cerebellopontine angle cistern in patients with trigeminal neuralgia. Journal of neurosurgery 2009; 110: 633-637
35 Fujiwara S, Sasaki M, Wada T et al. High-resolution diffusion tensor imaging for the detection of diffusion abnormalities in the trigeminal nerves of patients with trigeminal neuralgia caused by neurovascular compression. J Neuroimaging 2011; 21: e102-108
36 Jawahar A, Kondziolka D, Kanal E et al. Imaging the trigeminal nerve and pons before and after surgical intervention for trigeminal neuralgia. Neurosurgery 2001; 48: 101-106, discussion 6-7
37 Wilkins RH. Hemifacial spasm: a review. Surgical neurology 1991; 36: 251-277 [Review]
38 Jannetta PJ, Abbasy M, Maroon JC et al. Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients. Journal of neurosurgery 1977; 47: 321-328
39 Campos-Benitez M, Kaufmann AM. Neurovascular compression findings in hemifacial spasm. Journal of neurosurgery 2008; 109: 416-420
40 Naraghi R, Tanrikulu L, Troescher-Weber R et al. Classification of neurovascular compression in typical hemifacial spasm: three-dimensional visualization of the facial and the vestibulocochlear nerves. Journal of neurosurgery 2007; 107: 1154-1163
41 Raslan AM, DeJesus R, Berk C et al. Sensitivity of high-resolution three-dimensional magnetic resonance angiography and three-dimensional spoiled-gradient recalled imaging in the prediction of neurovascular compression in patients with hemifacial spasm. Journal of neurosurgery 2009; 111: 733-736
42 Jannetta PJ, Moller MB, Moller AR. Disabling positional vertigo. N Engl J Med 1984; 310: 1700-1705
43 Hufner K, Barresi D, Glaser M et al. Vestibular paroxysmia: diagnostic features and medical treatment. Neurology 2008; 71: 1006-1014
44 Ryu H, Yamamoto S, Sugiyama K et al. Neurovascular compression syndrome of the eighth cranial nerve. Can the site of compression explain the symptoms?. Acta Neurochir 1999; 141: 495-501
45 Gultekin S, Celik H, Akpek S et al. Vascular loops at the cerebellopontine angle: is there a correlation with tinnitus?. Am J Neuroradiol 2008; 29: 1746-1749
46 Hiwatashi A, Matsushima T, Yoshiura T et al. MRI of glossopharyngeal neuralgia caused by neurovascular compression. Am J Roentgenol 2008; 191: 578-581
47 Moon WJ, Roh HG, Chung EC. Detailed MR imaging anatomy of the cisternal segments of the glossopharyngeal, vagus, and spinal accessory nerves in the posterior fossa: the use of 3D balanced fast-field echo MR imaging. Am J Neuroradiol 2009; 30: 1116-1120
48 Linn J, Moriggl B, Schwarz F et al. Cisternal segments of the glossopharyngeal, vagus, and accessory nerves: detailed magnetic resonance imaging-demonstrated anatomy and neurovascular relationships. J Neurosurg 2009; 110: 1026-1041
49 Minagar A, Sheremata WA. Glossopharyngeal neuralgia and MS. Neurology 2000; 54: 1368-1370
50 Yousry I, Dieterich M, Naidich TP et al. Superior oblique myokymia: magnetic resonance imaging support for the neurovascular compression hypothesis. Ann Neurol 2002; 51: 361-368
51 Saglitz SA, Gaab MR. Investigations using magnetic resonance imaging: is neurovascular compression present in patients with essential hypertension?. Journal of neurosurgery 2002; 96: 1006-1012
52 Jannetta PJ, Gendell HM. Clinical observations on etiology of essential hypertension. Surg Forum 1979; 30: 431-432
53 Frank H, Heusser K, Geiger H et al. Temporary reduction of blood pressure and sympathetic nerve activity in hypertensive patients after microvascular decompression. Stroke 2009; 40: 47-51
54 Thuerl C, Rump LC, Otto M et al. Neurovascular contact of the brain stem in hypertensive and normotensive subjects: MR findings and clinical significance. Am J Neuroradiol 2001; 22: 476-480
55 Per H, Tucer B, Gumus H et al. Transient sixth nerve palsies and torticollis secondary to parietal arteriovenous malformation. Pediatr Neurosurg 2007; 43: 32-35
56 Panagiotopoulos V, Ladd SC, Gizewski E et al. Recovery of ophthalmoplegia after endovascular treatment of intracranial aneurysms. Am J Neuroradiol 2011; 32: 276-282
57 Heiland S, Hartmann M, Sartor K. [MR angiography: technical principles and uses in the diagnosis of neurological diseases]. Fortschr Röntgenstr 2001; 173: 677-685 [Comparative Study Review]