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Papers of the Week

2022 Sep 15

AJNR Am J Neuroradiol

Sagittal Angle of the Trigeminal Nerve at the Porus Trigeminus: A Novel Measurement to Distinguish Different Causes of Classic Trigeminal Neuralgia.


Classic trigeminal neuralgia is a clinical syndrome of facial pain, most often attributable to vascular compression of the proximal cisternal segment of the trigeminal nerve and treatable with microvascular decompression of the nerve. Some patients, however, meet all clinical criteria for classic trigeminal neuralgia yet do not respond to microvascular decompression. Because the reasons for surgical failure are not well understood, the aim of this study was to determine if a subset of patients with classic trigeminal neuralgia could be distinguished by measuring the angle of the trigeminal nerve in the sagittal plane as the nerve traverses the porus trigeminus.