Presentation
Intermittent right otalgia (each episode lasts for 5 minutes) and mild sensorineural hearing loss.
Patient Data
At the heavily T2 weighted high resolution scan (T2 MX3D) of posterior fossa, it shows the right superior cerebellar artery indents onto the right trigeminal nerve at the superior surface of the nerve near to the root entry zone (which is 2mm anterior to root entry zone).
Annotated images denote the nerve root entry right trigeminal nerve is being indented by right superior cerebellar artery at its superior surface. No external compression at left trigeminal nerve.
Case Discussion
Correlating with intermittent and excruciating pain of right otalgia, the presence of vascular compression of right superior cerebellar artery onto superior surface of right trigeminal nerve at nerve root entry zone raises high suspicion of right trigeminal neuralgia secondary due to vascular compression. No MR evidence of CP angle tumor or schwannoma.
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