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The Journal of Headache and Pain Jun 2020The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar... (Review)
Review
The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.
Topics: Animals; Brain Stem; Facial Pain; Headache; Humans; Trigeminal Ganglion; Trigeminal Nerve
PubMed: 32503421
DOI: 10.1186/s10194-020-01134-1 -
Swiss Dental Journal Dec 2017The face is a unique part of the body with its individual anatomical characteristics. While the dental clinician is usually focused on the oral cavity, the physical... (Review)
Review
The face is a unique part of the body with its individual anatomical characteristics. While the dental clinician is usually focused on the oral cavity, the physical examination should involve close attention to the neurosensory status of the facial skin. Furthermore, skin sensitivity should be assessed pre- and postoperatively in conjunction with dental interventions. The face can be divided into several functional units, such as the eyes, nose, mouth/lips, and cheeks. With regard to the neurosensory supply of the skin, various innervation territories of the face can be distinguished representing the three divisions of the trigeminal nerve. In addition, cutaneous branches of the cervical plexus provide sensitivity to the lower and lateral portions of the face. The objective of the present article is to provide the dental clinician with a literature update of the neurosensory innervation of the face.
Topics: Face; Humans; Mouth; Skin; Trigeminal Nerve
PubMed: 30920784
DOI: No ID Found -
NMR in Biomedicine Dec 2020Multidimensional correlation spectroscopy is emerging as a novel MRI modality that is well suited for microstructure and microdynamic imaging studies, especially of...
Multidimensional correlation spectroscopy is emerging as a novel MRI modality that is well suited for microstructure and microdynamic imaging studies, especially of biological specimens. Conventional MRI methods only provide voxel-averaged and mostly macroscopically averaged information; these methods cannot disentangle intra-voxel heterogeneity on the basis of both water mobility and local chemical interactions. By correlating multiple MR contrast mechanisms and processing the data in an integrated manner, correlation spectroscopy is able to resolve the distribution of water populations according to their chemical and physical interactions with the environment. The use of a non-parametric, phenomenological representation of the multidimensional MR signal makes no assumptions about tissue structure, thereby allowing the study of microscopic structure and composition of complex heterogeneous biological systems. However, until recently, vast data requirements have confined these types of measurement to non-localized NMR applications and prevented them from being widely and successfully used in conjunction with imaging. Recent groundbreaking advancements have allowed this powerful NMR methodology to be migrated to MRI, initiating its emergence as a promising imaging approach. This review is not intended to cover the entire field of multidimensional MR; instead, it focuses on pioneering imaging applications and the challenges involved. In addition, the background and motivation that have led to multidimensional correlation MR development are discussed, along with the basic underlying mathematical concepts. The goal of the present work is to provide the reader with a fundamental understanding of the techniques developed and their potential benefits, and to provide guidance to help refine future applications of this technology.
Topics: Algorithms; Animals; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Rats; Translational Research, Biomedical; Trigeminal Nerve
PubMed: 31909516
DOI: 10.1002/nbm.4226 -
Arquivos de Neuro-psiquiatria Jul 2014We reviewed trigeminal nerve stimulation (TNS) and transcutaneous vagus nerve stimulation (tVNS). All techniques have shown preliminary promising results, although the... (Meta-Analysis)
Meta-Analysis Review
UNLABELLED
We reviewed trigeminal nerve stimulation (TNS) and transcutaneous vagus nerve stimulation (tVNS). All techniques have shown preliminary promising results, although the results are mixed.
METHOD
We performed a systematic review of the Medline and Embase databases, with no constraint to dates, through June 2013. The keywords were [(1) trigeminal nerve stimulation OR (2) cranial nerve OR (3) trigemin* OR (4) transcutaneous VNS OR (5) transcutaneous cranial nerve stimulation] and (6) mental disorders.
RESULTS
We included four preclinical and clinical five studies on TNS. All clinical data were based on open-label studies with small samples, which diminished the external validity of the results, thus reflecting the modest impact of TNS in current clinical practice. Of the tVNS clinical trials, three assessed physiological features in healthy volunteers, and one examined patients with epilepsy.
CONCLUSION
TNS and tVNS improve treatment of particular neuropsychiatric disorders such as depression.
Topics: Female; Humans; Male; Mental Disorders; Nervous System Diseases; Transcutaneous Electric Nerve Stimulation; Treatment Outcome; Trigeminal Nerve; Vagus Nerve Stimulation
PubMed: 25054988
DOI: 10.1590/0004-282x20140061 -
Neurosurgery Jan 2019While high-resolution imaging is increasingly used in guiding decisions about surgical interventions for the treatment of trigeminal neuralgia, direct assessment of the...
BACKGROUND
While high-resolution imaging is increasingly used in guiding decisions about surgical interventions for the treatment of trigeminal neuralgia, direct assessment of the extent of vascular contact of the trigeminal nerve is still considered the gold standard for the determination of whether nerve decompression is warranted.
OBJECTIVE
To compare intraoperative and magnetic resonance imaging (MRI) findings of the prevalence and severity of vascular compression of the trigeminal nerve in patients without classical trigeminal neuralgia.
METHODS
We prospectively recruited 27 patients without facial pain who were undergoing microvascular decompression for hemifacial spasm and had undergone high-resolution preoperative MRI. Neurovascular contact/compression (NVC/C) by artery or vein was assessed both intraoperatively and by MRI, and was stratified into 3 types: simple contact, compression (indentation of the surface of the nerve), and deformity (deviation or distortion of the nerve).
RESULTS
Intraoperative evidence of NVC/C was detected in 23 patients. MRI evidence of NVC/C was detected in 18 patients, all of whom had intraoperative evidence of NVC/C. Thus, there were 5, or 28% more patients in whom NVC/C was detected intraoperatively than with MRI (Kappa = 0.52); contact was observed in 4 of these patients and compression in 1 patient. In patients where NVC/C was observed by both methods, there was agreement regarding the severity of contact/compression in 83% (15/18) of patients (Kappa = 0.47). No patients exhibited deformity of the nerve by imaging or intraoperatively.
CONCLUSION
There was moderate agreement between imaging and operative findings with respect to both the presence and severity of NVC/C.
Topics: Adult; Aged; Facial Nerve; Female; Hemifacial Spasm; Humans; Magnetic Resonance Imaging; Male; Microvascular Decompression Surgery; Middle Aged; Nerve Compression Syndromes; Neurosurgical Procedures; Prevalence; Prospective Studies; Trigeminal Nerve; Trigeminal Nerve Diseases; Trigeminal Neuralgia; Young Adult
PubMed: 29425330
DOI: 10.1093/neuros/nyx636 -
Turkish Journal of Medical Sciences Oct 2022Morphological differences that can lead the trigeminal nerve to neurovascular conflict and a new solitary pontine lesion are associated with the pathogenesis of...
BACKGROUND
Morphological differences that can lead the trigeminal nerve to neurovascular conflict and a new solitary pontine lesion are associated with the pathogenesis of trigeminal neuralgia (TN). In this case-control study, we aimed to contribute to the current discussions about the pathogenesis of TN by investigating the anatomical structures that may have an effect on the morphometric parameters of the trigeminal nerve.
METHODS
This study included 25 patients with TN followed up for pain in the Department of Algology, Faculty of Medicine, and 25 age- and gender-matched controls. We performed morphometric measurements including the length and volume of the trigeminal nerve, cerebellopontine cistern, pons, and posterior fossa in the MRIs of these individuals. Comparative analyses were performed for the mean of the affected and unaffected sides of the TN patients and the right, left, and both sides of the control group.
RESULTS
In patients with TN, on the affected side, length and volume of the trigeminal nerve and cerebellopontine cistern volume were found smaller than controls (p < 0.05). Pons volume was higher in patients with TN compared to controls (p < 0.05). The length of the affected nerve was significantly related to prepontine cistern length and cerebellopontine cistern volume (p < 0.05).
DISCUSSION
The cerebellopontine cistern volume has a significant impact on the morphometric characteristics of the trigeminal nerve. Especially, whether the increase in the volume of pons causes a decrease in the volume of cerebellopontine cistern should be clarified with further research.
Topics: Humans; Trigeminal Neuralgia; Case-Control Studies; Trigeminal Nerve; Pons; Magnetic Resonance Imaging
PubMed: 36422504
DOI: 10.55730/1300-0144.5503 -
Journal of Anatomy Jul 2021Supratentorial sensory perception, including pain, is subserved by the trigeminal nerve, in particular, by the branches of its ophthalmic division, which provide an... (Review)
Review
Supratentorial sensory perception, including pain, is subserved by the trigeminal nerve, in particular, by the branches of its ophthalmic division, which provide an extensive innervation of the dura mater and of the major brain blood vessels. In addition, contrary to previous assumptions, studies on awake patients during surgery have demonstrated that the mechanical stimulation of the pia mater and small cerebral vessels can also produce pain. The trigeminovascular system, located at the interface between the nervous and vascular systems, is therefore perfectly positioned to detect sensory inputs and influence blood flow regulation. Despite the fact that it remains only partially understood, the trigeminovascular system is most probably involved in several pathologies, including very frequent ones such as migraine, or other severe conditions, such as subarachnoid haemorrhage. The incomplete knowledge about the exact roles of the trigeminal system in headache, blood flow regulation, blood barrier permeability and trigemino-cardiac reflex warrants for an increased investigation of the anatomy and physiology of the trigeminal system. This translational review aims at presenting comprehensive information about the dural and brain afferents of the trigeminovascular system, in order to improve the understanding of trigeminal cranial sensory perception and to spark a new field of exploration for headache and other brain diseases.
Topics: Brain; Cerebral Arteries; Dura Mater; Headache; Humans; Trigeminal Nerve
PubMed: 33604906
DOI: 10.1111/joa.13413 -
Pain Physician Mar 2022The Gasserian ganglion (GG) is the primary neuronal aggregation area of the trigeminal nervous system and the epidural structure outside the central nervous system,...
BACKGROUND
The Gasserian ganglion (GG) is the primary neuronal aggregation area of the trigeminal nervous system and the epidural structure outside the central nervous system, thus, it has become the most commonly used target for minimally invasive treatment of trigeminal neuralgia (TN). Whether it is the classic trigeminal radiofrequency treatment or GG balloon compression therapy, the intervention target is the GG. The anatomy and imaging anatomy of the GG of the trigeminal nerve is of great importance in the minimally invasive treatment of TN.
OBJECTIVE
To study the anatomy of the trigeminal nerve and multimodal image fusion, and to provide a basis for a clinical minimally invasive interventional treatment forTN.
STUDY DESIGN
Review, clinical research study.
SETTING
Department of Anesthesiology and Pain Medical Center, Jiaxing, China.
METHODS
Dissect the general structure of the trigeminal nerve and its positional relationship with adjacent structures, and use computed tomography (CT) and magnetic resonance imaging (MRI) to observe the trigeminal nerve, and then, perform a fusion of the CT/MR images.
RESULTS
The GG of the trigeminal nerve is located in Meckel's cave of the middle cranial fossa, and the 3 branches of the nerve fibers are intertwined. CT could only clearly show the bony structures adjacent to the GG, rather than the GG in the body, which was inconsistent with MR images. The bony structure was blurred, while the Meckel's cave and nerve roots, where the trigeminal nerve is located, could be clearly distinguished. Fusing the CT/MR images could provide 2 complementary advantages.
LIMITATIONS
It does not prove the the balloon position thought to be a "dumbbell" shape is adequate for the successful treatment.
CONCLUSION
Based on the anatomical structure and position of the trigeminal nerve, it is difficult to achieve highly selective branch treatment of TN with radiofrequency in the GG. For the treatment of TN with percutaneous microballoon compression on the GG, the balloon catheter should be placed in Meckel's cave. While it is not easy to insert into Meckel's cave, the depth of the balloon catheter should be that the distal end is flush with the top of the temporal bone petrous cone.
Topics: Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Tomography, X-Ray Computed; Trigeminal Nerve; Trigeminal Neuralgia
PubMed: 35322984
DOI: No ID Found -
Pain Physician Jan 2019Temple headaches are common, yet the anatomic etiology of headaches in this region is often confusing. One possible cause of temple headaches is dysfunction of the...
BACKGROUND
Temple headaches are common, yet the anatomic etiology of headaches in this region is often confusing. One possible cause of temple headaches is dysfunction of the auriculotemporal nerve (ATN), a branch of the third division of the trigeminal nerve. However, the site of pain is often anterior to the described path of the ATN, and corresponds more closely to a portion of the path of a small branch of the second division of the trigeminal nerve called the zygomaticotemporal nerve (ZTN).
OBJECTIVES
We present the anatomic and clinical differences between these 2 nerves and describe treatment approaches. Diagnosis is made by physical examination of the temporal fossa and the temporomandibular joint, and injection of local anesthetic over the tenderest nerve.
RESULTS
In general, treatments of headaches that generated from the peripheral nerve attempt to neutralize the pain origin using surgical or interventional pain techniques to reduce nerve irritation and subsequently deactivate stimulated migraine centers.
CONCLUSIONS
Treatment of temporal nerve entrapment includes medications, nerve injections, dental appliances, cryoneuroablation, chemical neurolysis, neuromodulation, and surgical decompression.
KEY WORDS
Headache, migraine, trigeminal nerve, Frey's syndrome, zygomaticotemporal nerve, auriculotemporal nerve, temple pain, jaw pain, ear pain, tooth pain.
Topics: Headache; Humans; Male; Nerve Compression Syndromes; Trigeminal Nerve
PubMed: 30700076
DOI: No ID Found -
Australian Dental Journal Jun 2010Nerve surgery in the maxillofacial region is confined to the trigeminal and facial nerves and their branches. The trigeminal nerve can be damaged as a result of trauma,... (Review)
Review
Nerve surgery in the maxillofacial region is confined to the trigeminal and facial nerves and their branches. The trigeminal nerve can be damaged as a result of trauma, local anaesthesia, tumour removal and implant placement but the most common cause relates to the removal of teeth, particularly the inferior alveolar and lingual nerves following third molar surgery. The timing of nerve repair is controversial but it is generally accepted that primary repair at the time of injury is the best time to repair the nerve but it is often a closed injury and the operator does not know the nerve is injured until after the operation. Early secondary repair at about three months after injury is the most accepted time frame for repair. However, it is also thought that a reasonable result can be obtained at a later time. It is also generally accepted that the best results will be obtained with a direct anastamosis of the two ends of the nerve to be repaired. However, if there is a gap between the two ends, a nerve graft will be required to bridge the gap as the two ends of the nerve will not be approximated without tension and a passive repair is important for the regenerating axons to grow down the appropriate perineural tubes. Various materials have been used for grafting and include autologous grafts, such as the sural and greater auricular nerves, vein grafts, which act as a conduit for the axons to grow down, and allografts such as Neurotube, which is made of polyglycolic acid (PGA) and will resorb over a period of time.
Topics: Anastomosis, Surgical; Humans; Intraoperative Complications; Nerve Regeneration; Postoperative Complications; Time Factors; Trigeminal Nerve; Trigeminal Nerve Diseases; Trigeminal Nerve Injuries
PubMed: 20604750
DOI: 10.1111/j.1834-7819.2010.01216.x