D'Amico, A., Russo, C., Ugga, L., Mazio, F., Capone, E., D'Arco, F., Mankad, K., Caranci, F., Marano, E., Brunetti, A.
Can pontine trigeminal T2-hyperintensity suggest herpetic etiology of trigeminal neuralgia?
(2016) Quantitative Imaging in Medicine and Surgery, 6 (5), pp. 490-495.
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84994884887&partnerID=40&md5=2fdd743482a13368be8211db3120995e
DOI: 10.21037/qims.2016.01.07
AFFILIATIONS: Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy;
Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom;
Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
ABSTRACT: Background: Trigeminal neuralgia (TN) is usually classified into two different categories: idiopathic and secondary. We have investigated the frequency of brainstem pontine lesions in patients with idiopathic TN without multiple sclerosis (MS) or stroke, and their association with herpes zoster (HZ) infection. Methods: Brain magnetic resonance imaging (MRI) studies of 28 patients with TN were retrospectively reviewed. Results: We found seven patients with clinical suspicion of HZ infection and pontine T2 hyperintense lesions, associated with nerve atrophy in one case. Fifteen patients had a neurovascular conflict (NVC) without brainstem involvement, two of them associated with trigeminal atrophy, while four patients had only volumetric reduction of the nerve. In all patients MRI findings were ipsilateral to the side of TN. Conclusions: Pontine T2 hyperintensities could be considered as a MRI sign of TN in patients without NVCs. This "trigeminal pontine sign" (TPS) is frequently found in association with herpetic infections. © Quantitative Imaging in Medicine and Surgery. All rights reserved.
CORRESPONDENCE ADDRESS: D'Amico, A.; Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Italy; email: doctoralex@hotmail.it
