Nerve cells in the intracranial part of the trigeminal nerve of man and dog

1971 ◽  
Vol 34 (5) ◽  
pp. 643-646 ◽  
Author(s):  
Kamal Mousa Mira ◽  
Ibrahiem Abou Elnaga ◽  
Hassanein El-Sherif
Keyword(s):  
Trigeminal Nerve ◽  
Proximal Part ◽  
Nerve Fibers ◽  
Nerve Cells ◽  
Content Type ◽  
Specific Location ◽  
Nerve Bundles ◽  
Motor Root ◽  
Sensory Root ◽  
Fine Print

✓ Nerve cells histologically similar to the ganglionic cells of the trigeminal nerve were observed in the proximal part of the sensory root and in the motor root of the human trigeminal nerve. They were also seen in the sensory root of the trigeminal nerve of the dog. Counting of the nerve fibers showed doubling of the number of nerve fibers in the three divisions compared with the fibers in the sensory root adjacent to the trigeminal ganglion. There was also an increase in the number of fibers within the sensory root as it courses centrally, while a decrease was seen in the number of fibers in the proximal part of the motor root. Intermediate nerve bundles were seen leaving the motor root near the pons and joining the sensory root centrally. The fibers of the sensory root corresponding to each peripheral division maintained their specific location in the sensory root during the whole course centrally.

Detailed anatomy of the intracranial portion of the trigeminal nerve

1971 ◽  
Vol 35 (5) ◽  
pp. 592-600 ◽  
Author(s):  
Kristin Gudmundsson ◽  
Albert L. Rhoton ◽  
Joseph G. Rushton
Keyword(s):  
Posterior Fossa ◽  
Trigeminal Nerve ◽  
Sensory Loss ◽  
Content Type ◽  
The Third ◽  
Trigeminal Nerves ◽  
Motor Root ◽  
Sensory Root ◽  
Fine Print

✓ Fifty trigeminal nerves were studied at autopsy under various magnifications. Two findings that could explain the preservation of sensation after rhizotomy of the main sensory root are: 1) anastomosis between the motor and sensory root in the majority of nerves, and 2) aberrant sensory rootlets that arose from the pons separately from the main sensory root in one half of the nerves. The motor root is composed of as many as 14 separately originating rootlets that usually join about 1 cm from the pons. At the pontine level, the first division fibers are usually dorsomedial and the third division fibers caudolateral within the main sensory root. However, the third division fibers may vary from being almost directly lateral to directly caudal to the first division fibers. This may explain the variability of sensory loss with partial section in the posterior fossa.

Detailed anatomy of the motor and sensory roots of the trigeminal nerve and their neurovascular relationships: a magnetic resonance imaging study

2004 ◽  
Vol 101 (3) ◽  
pp. 427-434 ◽  
Author(s):  
Indra Yousry ◽  
Bernhard Moriggl ◽  
Markus Holtmannspoetter ◽  
Urs D. Schmid ◽  
Thomas P. Naidich ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Trigeminal Nerve ◽  
Mr Angiography ◽  
Three Dimensional ◽  
Content Type ◽  
Cerebellar Artery ◽  
Motor Root ◽  
Sensory Root ◽  
Angiography Sequences ◽  
Fine Print

Object. The trigeminal nerve conducts both sensory and motor impulses. Separate superior and inferior motor roots typically emerge from the pons just anterosuperomedial to the entry point of the sensory root, but to date these two motor roots have not been adequately displayed on magnetic resonance (MR) images. The specific aims of this study, therefore, were to identify the superior and inferior motor roots, to describe their exact relationship to the sensory root, and to assess the neurovascular relationships among all three roots of the trigeminal nerve. Methods. Thirty-three patients and seven cadaveric specimens (80 sides) were studied using three-dimensional (3D) Fourier transform constructive interference in steady-state (CISS) imaging. The 33 patients were also studied by obtaining complementary time-of-flight (TOF) MR angiography sequences with and without contrast enhancement. At least one motor root was identified in all sides examined: in 51.2% of the sides a single motor root, in 37.5% two motor roots, and in 11.2% three motor roots. The superior cerebellar artery (SCA) and the anterior inferior cerebellar artery (AICA) contacted the sensory root in 45.5% of patients and 42.9% of specimens. The SCA often contacted the superior motor root (48.5% of patients and 50% of specimens) and less frequently the inferior motor root (26.5% of patients and 20% of specimens). Conclusions. Three-dimensional CISS and complementary 3D TOF MR angiography sequences reliably display sensory, superior motor, and inferior motor roots of the trigeminal nerve and their relationships to the SCA and AICA.

Relation of the accessory rootlets of the trigeminal nerve to its motor root

1970 ◽  
Vol 33 (3) ◽  
pp. 317-324 ◽  
Author(s):  
Richard L. Saunders ◽  
Ernest Sachs
Keyword(s):  
Trigeminal Nerve ◽  
Content Type ◽  
Autopsy Specimens ◽  
Trigeminal Nerves ◽  
Motor Root ◽  
Fine Print

✓ Microsurgical dissection of trigeminal nerves in autopsy specimens demonstrates that the so-called “accessory rootlets” are really a component of the motor root. This confirms Meckel's description of 1748.

Surgical treatment of cluster headache

1990 ◽  
Vol 72 (6) ◽  
pp. 866-871 ◽  
Author(s):  
Joel C. Morgenlander ◽  
Robert H. Wilkins
Keyword(s):  
Surgical Treatment ◽  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Content Type ◽  
Pain Pathways ◽  
Autonomic Disturbances ◽  
Sensory Root ◽  
Fine Print ◽  
Nervus Intermedius

✓ Cluster headache is ordinarily managed medically, but may become refractory to such medical management. In this setting, surgical treatment has occasionally been performed, based on evidence that pertinent pain pathways and parasympathetic pathways may be interrupted at the main sensory root of the trigeminal nerve and at the nervus intermedius. Between 1976 and 1987, 13 patients underwent surgery for treatment of cluster headache that was refractory to medical therapy (15 procedures). Partial sectioning of the main sensory root and sectioning of the nervus intermedius were performed in nine patients; only partial sectioning of the main sensory root in one; only sectioning of the nervus intermedius in one; and nervus intermedius sectioning plus microvascular decompression of the trigeminal nerve in two. The average postoperative period for the 13 patients was 37 months (range 2 to 135 months). All patients had return of their headaches postoperatively except for one patient who obtained relief after a repeat procedure. Headache began to return between 2 days and 2 years postoperatively. Three patients are currently free of headache, including both patients who had nervus intermedius sectioning plus microvascular decompression of the trigeminal nerve. Together with recurrence of headache, cluster-associated autonomic disturbances recurred after 14 of the 15 operations but are currently absent in the three headache-free patients. Partial sectioning of the main sensory root and sectioning of the nervus intermedius, as performed in these patients, seem to have limited value in the treatment of cluster headache.

Subdivision of the trigeminal sensory root

1971 ◽  
Vol 35 (5) ◽  
pp. 585-591 ◽  
Author(s):  
W. Frank Emmons ◽  
Albert L. Rhoton
Keyword(s):  
Trigeminal Nerve ◽  
Rhesus Monkeys ◽  
Content Type ◽  
Sensory Nucleus ◽  
Trigeminal Root ◽  
Spinal Nucleus ◽  
Degeneration Techniques ◽  
Rostral Portion ◽  
Motor Root ◽  
Sensory Root

✓ In 16 rhesus monkeys, rhizotomy of the whole trigeminal nerve and selective rhizotomy of each division were carried out, and neural degeneration techniques used, to determine whether a trigeminal root component exists which projects only to the main sensory or spinal nucleus of the trigeminal nerve. Such a root component was not found. Section of the rostral trigeminal fibers resulted in degeneration in both the main sensory nucleus and the spinal trigeminal nucleus. Section of the caudal fibers of the root produced degeneration similar to third division transection, indicating that the caudal fibers are from that division. The first- and third-division fibers were found to project to the ventral and dorsal portions of the main sensory nucleus and spinal nucleus. Findings showed that the most rostral portion of the root immediately adjacent to the motor root is predominately from the ophthalmic division. Some proprioception from the trigeminal area appears to be mediated through the medial cuneate nucleus because all the trigeminal divisions send some fibers to this nucleus.

Clinical and electrophysiological studies on sensory conduction mediated by the accessory rootlets of the human trigeminal nerve

1975 ◽  
Vol 42 (5) ◽  
pp. 513-521 ◽  
Author(s):  
Adolfo Ley ◽  
Luis Montserrat ◽  
Fernando Bacci ◽  
Adolfo Ley
Keyword(s):  
Trigeminal Nerve ◽  
Blink Reflex ◽  
Content Type ◽  
Sensory Conduction ◽  
Before And After ◽  
Electrophysiological Studies ◽  
Sensory Fibers ◽  
Sensory Root ◽  
Fine Print ◽  
Stimulation Of

✓ The authors present records of potentials evoked in the roots of the trigeminal nerve by stimulation of its cutaneous branches. Records were made during nine operations for tic douloureux in which the main sensory root of the trigeminal nerve was totally sectioned under the microscope by the transcerebellar route. In every case, the accessory (aberrant) and motor roots were easily identified and spared. Records before and after total main sensory root division showed persistence of evoked potentials in the aberrant and motor fibers. Partial preservation of sensation and blink reflex in these cases reinforced the impression that there is somatic sensory conduction through true aberrant sensory fibers running between the motor and main sensory roots.

Clip-grafts in microvascular decompression of the posterior fossa

1986 ◽  
Vol 64 (4) ◽  
pp. 679-681 ◽  
Author(s):  
Edward R. Laws ◽  
Patrick J. Kelly ◽  
Thoralf M. Sundt
Keyword(s):  
Posterior Fossa ◽  
Trigeminal Nerve ◽  
Microvascular Decompression ◽  
Content Type ◽  
Trigeminal Root ◽  
Vascular Irritation ◽  
Sensory Root ◽  
Fine Print

✓ A method is described for the protection of the trigeminal root from recurrent vascular irritation or compression after posterior fossa microvascular decompression. A vascular clip-graft, using a Sundt clip of suitable size, is applied to the sensory root of the trigeminal nerve. The technique has proven safe and effective in a series of nine patients followed for up to 28 months.

Transcorneal stimulation of trigeminal nerve afferents to increase cerebral blood flow in rats with cerebral vasospasm: a noninvasive method to activate the trigeminovascular reflex

2002 ◽  
Vol 97 (5) ◽  
pp. 1179-1183 ◽  
Author(s):  
Basar Atalay ◽  
Hayrunnisa Bolay ◽  
Turgay Dalkara ◽  
Figen Soylemezoglu ◽  
Kamil Oge ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cerebral Vasospasm ◽  
Trigeminal Nerve ◽  
Nerve Endings ◽  
Noninvasive Method ◽  
Direct Stimulation ◽  
Content Type ◽  
Fine Print ◽  
Stimulation Of

Object. The goal of this study was to investigate whether stimulation of trigeminal afferents in the cornea could enhance cerebral blood flow (CBF) in rats after they have been subjected to experimental subarachnoid hemorrhage (SAH). Cerebral vasospasm following SAH may compromise CBF and increase the risks of morbidity and mortality. Currently, there is no effective treatment for SAH-induced vasospasm. Direct stimulation of the trigeminal nerve has been shown to dilate constricted cerebral arteries after SAH; however, a noninvasive method to activate this nerve would be preferable for human applications. The authors hypothesized that stimulation of free nerve endings of trigeminal sensory fibers in the face might be as effective as direct stimulation of the trigeminal nerve. Methods. Autologous blood obtained from the tail artery was injected into the cisterna magna of 10 rats. Forty-eight and 96 hours later (five rats each) trigeminal afferents were stimulated selectively by applying transcorneal biphasic pulses (1 msec, 3 mA, and 30 Hz), and CBF enhancements were detected using laser Doppler flowmetry in the territory of the middle cerebral artery. Stimulation-induced changes in cerebrovascular parameters were compared with similar parameters in sham-operated controls (six rats). Development of vasospasm was histologically verified in every rat with SAH. Corneal stimulation caused an increase in CBF and blood pressure and a net decrease in cerebrovascular resistance. There were no significant differences between groups for these changes. Conclusions. Data from the present study demonstrate that transcorneal stimulation of trigeminal nerve endings induces vasodilation and a robust increase in CBF. The vasodilatory response of cerebral vessels to trigeminal activation is retained after SAH-induced vasospasm.

Targeting the cranial nerve: microradiosurgery for trigeminal neuralgia with CISS and 3D-Flash MR imaging sequences

2005 ◽  
Vol 102 ◽  
pp. 107-110 ◽  
Author(s):  
Vasilios A. Zerris ◽  
Georg C. Noren ◽  
William A. Shucart ◽  
Jeff Rogg ◽  
Gerhard M. Friehs
Keyword(s):  
Mr Imaging ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Cranial Nerve ◽  
Fusion Imaging ◽  
Vascular Compression ◽  
Content Type ◽  
History Of ◽  
Fine Print

Object.The authors undertook a study to identify magnetic resonance (MR) imaging techniques that can be used reliably during gamma knife surgery (GKS) to identify the trigeminal nerve, surrounding vasculature, and areas of compression.Methods.Preoperative visualization of the trigeminal nerve and surrounding vasculature as well as targeting the area of vascular compression may increase the effectiveness of GKS for trigeminal neuralgia. During the past years our gamma knife centers have researched different MR imaging sequences with regard to their ability to visualize cranial nerves and vascular structures. Constructive interference in steady-state (CISS) fusion imaging with three-dimensional gradient echo sequences (3D-Flash) was found to be of greatest value in the authors' 25 most recent patients.In 24 (96%) out of the 25 patients, the fifth cranial nerve, surrounding vessels, and areas of compression could be reliably identified using CISS/3D-Flash. The MR images were acceptable despite patients' history of microvascular decompression, radiofrequency (RF) ablation, or concomitant disease. In one of 25 patients with a history of multiple RF lesions, the visualization was inadequate due to severe trigeminal nerve atrophy.Conclusions.The CISS/3D-Flash fusion imaging has become the preferred imaging method at the authors' institutions during GKS for trigeminal neuralgia. It affords the best visualization of the trigeminal nerve, surrounding vasculature, and the precise location of vascular compression.

Trigeminal schwannoma

1988 ◽  
Vol 69 (6) ◽  
pp. 850-860 ◽  
Author(s):  
Paul C. McCormick ◽  
Jacqueline A. Bello ◽  
Kalmon D. Post
Keyword(s):  
Trigeminal Nerve ◽  
Surgical Approach ◽  
Csf Leak ◽  
Symptom Duration ◽  
Consecutive Series ◽  
Nerve Function ◽  
Content Type ◽  
Trigeminal Schwannoma ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ A consecutive series of 14 patients with trigeminal schwannoma managed surgically at the Neurological Institute of New York since 1970 is reported. Nine women and five men (mean age 40 years) were diagnosed following a mean symptom duration of 33 months. Abnormalities of trigeminal nerve function were present in 11 patients on admission examination. Facial pain was a prominent feature in eight patients. Two patients, both with schwannomas arising from the trigeminal root, presented initially with typical trigeminal neuralgia. Additional cranial nerve palsies or cerebellar or pyramidal tract signs were noted in eight patients. The surgical approach to these tumors depends on their anatomical location. Four patients had tumors confined to the middle fossa, three patients had tumors limited to the posterior fossa, and seven patients had both supratentorial and infratentorial components of their tumors. Twenty operative procedures were performed on these patients, resulting in complete extirpation in six patients, nearly complete removal in seven patients, and partial removal in one patient. Adherence of the tumor to the lateral wall of the cavernous sinus or the brain stem precluded total removal. There was one postoperative death. In the immediate postoperative period, abnormalities of cranial nerves controlling the extraocular muscles were common. In general, these deficits were transient; however, some permanent loss of trigeminal nerve function occurred in nine patients. Two patients required tarsorrhaphy for neurotropic keratitis, and two patients underwent cerebrospinal fluid (CSF) shunting procedures for hydrocephalus or for a persistent CSF leak. The follow-up period ranged from 4 to 177 months (mean 47 months). The clinical features, anatomical considerations, and surgical approach to these rare tumors are discussed. A clinical review of 106 additional cases of trigeminal schwannoma, reported in the English literature since 1935, is also presented.

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