Imaging Studies of Two Cases of Trigeminal Neuralgia Caused by a Dolichoectatic Vertebrobasilar System

椎基底動脈擴張導致之三叉神經痛：應用電腦斷層血管攝影及磁振血管攝影診斷之二例病例報告

阮春榮(Chun-Jung Juan) ； 陳震宇(Cheng-Yu Chen) ； 薛俊仁(Chun-Jen Hsueh) ； 徐先和(Hsian-He Hsu) ； 秦嗣騏(Shy-Chi Chin) ； 李國維(Kwo-Wei Lee) ； 李重臣(Chueng-Chen Lee) ； 蕭海松(Hai-Sung Hsiao)

《中華放射線醫學雜誌》 24卷1期 (1999/02) Pp. 41-45

摘要

兩位罹患因擴張之基底動脈或椎動脈所導致之三叉神經痛之男性分別接受電腦斷層血管攝影或磁振血管攝影之診斷。第一位病患之電腦斷層血管攝發現椎基底動脈明顯擴張、彎曲至右側小腦髓腦角並造成右側第五對腦神經之壓迫。第二位病患不僅在磁振血管攝影顯示出彎曲、擴張之椎動脈，並且清楚的指出第五對腦神經在神經根進入區被壓迫之處。此外，左側後下小腦動脈亦明顯地壓迫第五對腦神經的神經根進入區。對於罹患三叉神經痛的病患，磁振造影合併磁振血管攝影提供絕佳的術前診斷，包括確定並完整地顯示造成神經壓迫的血管，提供致病的血管與被壓迫的神經之間精確的解剖關係，以及排除血管壓迫以外的病因諸如腫瘤，表皮性囊腫，蛛網膜囊腫，以及多發性硬化等。

關鍵字

三叉神經痛 ； 椎基底動脈，擴張 ； 電腦斷層攝影，血管攝影 ； 磁振造影，血管攝影

並列摘要

Two men with trigeminal neuralgia caused by trigeminal nerve compression from the dolichoectatic basilar and vertebral arteries were diagnosed, one by CTA (computed tomographic angiography) and the other by MRA (magnetic resonance angiography). In one case, CTA showed marked ectatic vertebrobasilar arteries, which deviated to the right cerebellopontine angle with compression of the right fifth nerve. In the second case, the root entry zone (REZ) of the left fifth crania! nerve compressed by the left tortuous, dolichoectatic vertebral artery and the left posterior inferior cerebellar artery (PICA) was demonstrated on MRI together with reconstructed MRA. In a patient with trigeminal neuralgia, MRI combined with reconstructed MRA provides a satisfactory preoperative diagnosis by showing the course of the pathologic vessels and the precise anatomic relationship between the causative vessels and the compressed trigeminal nerve, and by excluding other etiologies such as tumors, epidermoid cysts, arachnoid cysts and multiple sclerosis.

並列關鍵字

Trigeminal neuralgia ； Vertebrobasilar artery, dolichoectasia ； Computed tomography CT, angiography ； Magnetic resonance MR, angiography