Skip to main content

Magnetic resonance imaging criteria in vascular compression syndrome




The aim of this work is to show the imaging criteria of the offending vessel in neurovascular compression syndrome in the cerebellopontine angle using MRI. This will increase the acceptance of the concept of vascular compression syndrome of the cranial nerves as an etiology of trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, and some cases of disabling vertigo and tinnitus.

Materials and methods

Between 1994 and 2008, MRI radiographs of 782 cases of vasculoneural compression were reviewed to analyze the imaging criteria of the offending vascular loop and were correlated with intraoperative vascular decompression findings in various pathologies such as hemifacial spasm, trigeminal neuralgia, glossopharyngeal neuralgia, vertigo, and tinnitus.


The specificity and high sensitivity of the T2 constructive interference in steady state or fast spin eco sequence MRI allowed us to precisely define the vasculoneural conflict in almost all cases and to highlight certain radiological criteria required for a vasculoneural conflict diagnosis in general. These criteria are mainly the presence of a vascular loop that is perpendicular to the course of the nerve and the presence of distortion of the neural structures.


MRI in the T2 sequence is the key assessment in neurovascular compression syndrome.


  1. Matsushima T, Rhoton AL, Lenkey C. Microsurgery of the fourth microsurgical anatomy. Neurosurgery. 1982; 11: 631–667.

    Article  CAS  Google Scholar 

  2. Jannetta PJ. Microsurgery of cranial nerve cross-compression. Clin Neurosurg. 1979; 26: 607–615.

    Article  CAS  Google Scholar 

  3. White JC, Sweet WH. Facial and cephalic neuralgia. In: White JC, Sweet WH, editors. Pain its mechanisms and neurological control. Springfield, Illinois: Charles C. Thomas; 1955. pp. 433–493.

    Google Scholar 

  4. Katusic S, Beard CM, Bergstralh E, Kurland LT. Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota 1945–1984. Ann Neurol. 1990; 27: 89–95.

    Article  CAS  Google Scholar 

  5. Loser JD. Tic douloureux and atypical facial pain. In: Wall PD, Melzack R, editors. Textbook of bain. New York, NY: Churchill Livingstone; 1984. pp. 426–434.

    Google Scholar 

  6. Auger Rg, Whisnant JP. Hemifacial spasm in Rodhester and Olmsted County, Minnnesota, 1960 to 1984. Arch Neurol. 1990;47:1233–1234.

    Article  CAS  Google Scholar 

  7. Diger K, Corbett JJ. Hemifacial spasm: differential diagnosis mechanism and treatment. Adv Neurol. 1988; 39: 151–176.

    Google Scholar 

  8. Jannetta PJ. Cranial rhizopathies. In: Ypumans JR, editor. Neurological surgery: a comprehensive reference guide to the diagnosis and management of neurosurgical problems. 3rd ed. Philadelphia, PA: WB Saunders Co; 1990. pp. 4169–4182.

    Google Scholar 

  9. Wilkins RH. Hemifacial spasm: treatment by microvascular decompression of the facial nerve at the pons. South Med J. 1981; 74: 1471–1474.

    Article  CAS  Google Scholar 

  10. Gardener WJ. Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg. 1962; 19: 947–958.

    Article  Google Scholar 

  11. Ferguson JH. Hemifacial spasm and the facial nucleus. Ann Neurol. 1978; 4: 97–103.

    Article  CAS  Google Scholar 

  12. Nielsen VK. Pathophysiology of hemifacial spasm, II: lateral spread of the supraorbital nerve reflex. Neurology. 1984:427–431.

  13. Terrence CF, Sax M, Fromm GH, et al. Effect of baclofen enantiomorphs on the spinal trigeminal nucleus and steric similarities of carbamazebine. Pharmacology. 1983; 27: 85–94.

    Article  CAS  Google Scholar 

  14. Esteban A, Molina-Negro P. Primary hemifacial spasm: a neurophysiological study. J Neural Neurosurg Psychiatry. 1986; 49: 58–63.

    Article  CAS  Google Scholar 

  15. Gardener WJ. Crosstalk: the paradoxical transmission of a nerve impulse. Arch Neurol. 1966; 14: 149–156.

    Article  Google Scholar 

  16. Fromm GH. Effects of different classes of antiepileptic drugs on brain-stem pathways. Fed Proc. 1985; 44: 2432–2435.

    CAS  PubMed  Google Scholar 

  17. Fromm GH. Pathophysiology of trigeminal neuralgia. In: Fromm GH, Sessel BJ, editors. Trigeminal neuralgia: current concepts regarding pathogenesis and treatment. Boston, Massachusetts: Butterworth Heinemann; 1991. pp. 105–130.

    Google Scholar 

  18. Howe JF, Calvin WH, Loeser JD. Impulses reflected from dorsal root ganglia and from focal nerve injuries. Brain Res. 1976; 116: 139–144.

    Article  CAS  Google Scholar 

  19. Magnan J, Chays A, Broder L, Bruzzo M, ElGarem H, Girard N, Raybaud C. Treatment of neuro-vascular conflict in the cerbello pontine angle. Radiology. 1999; 19: 63–72.

    Google Scholar 

  20. Girard N, Poncet M, Caces F, Tallon Y, Chays A, Martin-Bouyer P, et al. Three dimensional MRI of hemifacial spasm with surgical correlation. Neuroradiology. 1977; 39: 46–51.

    Article  Google Scholar 

  21. Elaini Sh, Miyazaki H, Rameh C, Deveze A, Magnan J. Correlation between magnetic resonance imaging and surgical findings in vasculo-neural compression syndrome. J Int Adv Otol. 2009;5(Suppl):1–23.

    Google Scholar 

  22. Elaini Sh, Magnan J, Deveze A, Lavielle JP, Girard N. Neuro-vascular compression in the cerebello pontine angle (CPA): radiological and endoscopic assessment. Egyptian Military Medical Journal. 2010;65:3–7.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Sherif Elaini MD.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elaini, S., Magnan, J., Deveze, A. et al. Magnetic resonance imaging criteria in vascular compression syndrome. Egypt J Otolaryngol 29, 10–15 (2013).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: