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  3. Trigeminal neuralgia caused by an arachnoid cyst in Meckel’s cave

Trigeminal neuralgia caused by an arachnoid cyst in Meckel’s cave

Findings:
A cystic lesion is seen within the right Meckel’s cave with no nodularity or enhancement. The lesion elicits fluid signal intensity and extends posteriorly to the right cerebellopontine angle. This displaces and compresses the cavernous portion of the right trigeminal nerve. No involvement of the petrous apex. No abnormalities seen on the left side.
Mild involutional changes are seen in the brain parenchyma in the form of prominent cortical sulci and widened ventricles.There is no midline shift.
The brain parenchyma is unremarkable. No diffusion restriction.
Mucosal thickening is seen in the paranasal sinuses bilaterally. The mastoid air cells are clear.
No bony abnormality is seen.

Conclusion:
Cystic mass lesion in the right Meckel’s cave is likely in keeping with a small arachnoid cyst extending from the right cerebellopontine angle to the right Meckel’s cave. No nodular or enhancing components.

Updated on 15. May 2023

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About the author

Dr Sara Mohebbi is a Consultant Radiologist (Facharzt für Radiologie) with sub-specialty training in neuroradiology. She served as Chief Resident at University Hospital Freiburg and is a member of the European Society of Radiology (ESR). Her clinical focus includes demyelinating disease, neuro-oncology, and vascular neuroimaging. Dr Mohebbi is the Clinical Lead at Radiology Prime, where she provides independent second opinion reports on brain and spine MRI.