Magnetic resonance imaging-based classification of trigeminal nerve-superior cerebellar artery relationships

Q: What was the study’s main objective regarding the SCA and TN?

To examine the spatial relationship between the SCA and TN using high-resolution MRI and determine whether specific anatomical configurations predispose to clinically significant contact.

Q: How were the SCA–TN relationships assessed in the methods?

MRI scans from 80 patients (160 sides) were retrospectively analyzed, identifying the TN root and evaluating its spatial relationship with the SCA using multiplanar reconstruction while excluding cases with TN-affecting pathology.

Q: Which configurations were most associated with clinically relevant contact?

Medial and superior configurations were linked to shorter artery–nerve distances and significantly higher contact rates, with some cases also showing ipsilateral facial numbness.

Sep 28, 2026

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High-resolution magnetic resonance imaging was used to investigate how the superior cerebellar artery (SCA) relates spatially to the trigeminal nerve (TN) and whether specific anatomical configurations increase clinically significant vascular contact. Retrospective analysis of 80 patients (160 sides) excluded cases with pathological processes affecting the TN. Eight topographic SCA–TN patterns were identified; contact was common overall but symptoms were uncommon, with medial and superior configurations showing the strongest association with shorter distance and higher contact rates. Findings support incorporating geometry and nerve alterations into preoperative assessment rather than relying on contact alone.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Aim

Methods

Results

Conclusion

Introduction

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| W | J | R | World Journal of
Radiology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Radiol 2025 December 28; 17(12): 116453 DOI: 10.4329/wjr.v17.i12.116453 ISSN 1949-8470 (online) ORIGINAL ARTICLE Retrospective Study Magnetic resonance imaging-based classification of trigeminal nerve-superior cerebellar artery relationships George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Nikolaos-Achilleas Arkoudis, Ornella MoschovakiZeiger, Georgios Velonakis, Maria Piagkou Specialty type: Radiology, nuclear medicine and medical imaging Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade A Novelty: Grade A Creativity or Innovation: Grade A Scientific Significance: Grade A P-Reviewer: Doi K, MD, Chief, Director, Japan Received: November 12, 2025 Revised: November 25, 2025 Accepted: December 10, 2025 Published online: December 28, 2025 Processing time: 44 Days and 21.3 Hours George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Maria Piagkou, Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens 11527, Attikí, Greece Panagiotis Papadopoulos-Manolarakis, Department of Neurosurgery, General Hospital of Nikaia-Piraeus, Athens 18454, Attikí, Greece Nikolaos-Achilleas Arkoudis, Georgios Velonakis, Research Unit of Radiology and Medical Imaging, National and Kapodistrian University of Athens, Athens 11528, Attikí, Greece Nikolaos-Achilleas Arkoudis, Ornella Moschovaki-Zeiger, Georgios Velonakis, Second Department of Radiology, General University Hospital “Attikon”, National and Kapodistrian University of Athens, Athens 12462, Attikí, Greece Corresponding author: Maria Piagkou, DDS, MD, PhD, Professor, Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens 11527, Attikí, [Greece.](Greece. mapian@med.uoa.gr)[ mapian@med.uoa.gr](Greece. mapian@med.uoa.gr) Abstract BACKGROUND The trigeminal nerve (TN) is frequently implicated in neurovascular conflicts, most commonly with the superior cerebellar artery (SCA), its predominant arterial counterpart in the cerebellopontine angle. AIM To examine the relationship between the SCA and TN utilizing high-resolution magnetic resonance imaging and evaluated whether particular anatomical configurations predispose to clinically significant contact. METHODS Magnetic resonance imaging scans from 80 patients (160 sides) were retrospectively analyzed, excluding cases with pathological processes affecting the TN. Using multiplanar reconstruction, the TN root was identified and its spatial relationship with the SCA was evaluated. RESULTS Eight distinct topographic patterns were identified. The SCA most commonly WJR [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 28, 2025 Volume 17 Issue 12 Triantafyllou G et al. Neurovascular relationship classification coursed superior (30.6%), lateral (18.8%), or superolateral (17.5%) to the TN. Medial configurations, although less frequent, were associated with the shortest artery-nerve distance (mean 1.85 ± 1.28 mm) and significantly higher contact rates (P < 0.001) . Overall, SCA-TN contact was observed in 14.4% of sides, but only 20% of these patients reported ipsilateral facial numbness. Variations in SCA origin (basilar artery, posterior cerebral artery, or common origin) and duplication did not significantly influence the artery-nerve distance. CONCLUSION Although SCA-TN contact is relatively frequent, only particular medial and superior configurations seem to predispose individuals to symptomatic compression. These observations are consistent with cadaveric and surgical evidence highlighting the significance of root entry

FAQs

What was the study’s main objective regarding the SCA and TN?

To examine the spatial relationship between the SCA and TN using high-resolution MRI and determine whether specific anatomical configurations predispose to clinically significant contact.

How were the SCA–TN relationships assessed in the methods?

MRI scans from 80 patients (160 sides) were retrospectively analyzed, identifying the TN root and evaluating its spatial relationship with the SCA using multiplanar reconstruction while excluding cases with TN-affecting pathology.

Which configurations were most associated with clinically relevant contact?

Medial and superior configurations were linked to shorter artery–nerve distances and significantly higher contact rates, with some cases also showing ipsilateral facial numbness.

Sep 28, 2026

Uploaded by Guten tag