Korean J Neurotrauma.  2019 Apr;15(1):38-42. 10.13004/kjnt.2019.15.e10.

Trigeminal Neuralgia Resulting from Delayed Cervical Cord Compression after Acute Traumatic Fracture of Odontoid Process

• Shim YW
• Paeng SH
• Lee KS
• Kim ST
• Lee WH

• KMID: 2444204
• DOI: http://doi.org/10.13004/kjnt.2019.15.e10

Abstract

Trigeminal neuralgia is caused by compression of trigeminal nerve root and it leads to demyelination gradually. It was almost idiopathic and occurred unexpected. The upper cervical spinal cord contains the spinal trigeminal tract and nucleus. Fibers with cell bodies in the trigeminal ganglion enter in the upper pons and descend caudally to C2 level. We experienced a rare patient with facial pain, which was paroxysmal attack with severe pain after a clear event, cervical spinal injury (C2). So, this case reminds us of a possible cause of trigeminal neuralgia after a trauma of the head and neck.

Keyword

Trigeminal neuralgia; Spinal injury; Spinal cord

MeSH Terms

Cell Body
Cervical Cord*
Demyelinating Diseases
Facial Pain
Head
Humans
Neck
Odontoid Process*
Pons
Spinal Cord
Spinal Injuries
Trigeminal Ganglion
Trigeminal Nerve
Trigeminal Neuralgia*

Figure

• 

  FIGURE 1 The computed tomography (A) reveals odontoid process fracture, type II (white arrow), T2-weighted fat suppression magnetic resonance imaging (B) shows high signal change in C2 posterior complex areas.

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  FIGURE 2 Sagittal (A) and axial (B) T2 weighted magnetic resonance imaging shows increased atlantoaxial interval with decreased anteroposterior diameter of bony central canal, causing compressive myelopathy of C1/2 (white arrow). The computed tomography (C) shows narrow spinal canal due to C1/2 instability. The lateral radiography on flexion (D) and extension (E) shows C1/2 instability.

• 

  FIGURE 3 Spinal trigeminal tract descending as far as Caudal medulla and ascending through spinothalamic tract (A, sagittal view) Three branch of central trigeminal bundle connecting with trigeminal nucleus in pons (B, axial view).

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