Cranial Nerves III to VI

Robert W. Evers1, David M. Yousem1

1 The Johns Hopkins Hospital, Baltimore, Maryland
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A7.2
DOI:  10.1002/0471142719.mia0702s00
Online Posting Date:  May, 2001
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Abstract

Cranial nerves III, IV, V, and VI are small structures that travel in a reproducible manner from the midbrain and pons to the cavernous sinus and then to the orbit. While there are branches that course through other foramina of the skull, the emphasis in MRI is to evaluate the brainstem, the cavernous sinus, and the pericavernous regions for pathology. This unit present a basic protocol for imaging cranial nerves III to VI. Because the nerves run from a posterior to an anterior position, coronal scanning is ideal for visualizing the nerves in cross‐section. Thin sections and contrast enhancement are required to best visualize the diseases that affect these nerves. An alternate protocol is also discussed for the case when demyelinating etiologies for the cranial nerve deficits are considered.

     
 
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Table of Contents

  • Basic Protocol 1: Imaging of Cranial Nerves III to VI
  • Alternate Protocol 1: Demyelinating Etiologies: Aneurysms
  • Commentary
  • Literature Cited
  • Tables
     
 
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Materials

Basic Protocol 1: Imaging of Cranial Nerves III to VI

  Materials
  • Normal saline (0.9% NaCl), sterile
  • Gadolinium‐based MR contrast agent (e.g., Magnevist, Omniscan, or Prohance)
NOTE: Be sure that technicians and nurses have immediate access to any emergency equipment that may be relevant to a given study, or that may be needed for a particular patient, such as crash carts or oxygen.
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Figures

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Literature Cited

Literature Cited
   Castillo, M. and Mukherji, S.K. 1996a. Magnetic resonance imaging of cranial nerves IX, X, XI, and XII. Top. Magn. Reson. Imaging 8:180‐186.
   Castillo, M. and Mukherji, S.K. 1996b. MRI of enlarged dorsal ganglia, lumbar nerve roots, and cranial nerves in polyradiculoneuropathies. Neuroradiology 38:516‐520.
   Chong, V.F. 1996. Trigeminal neuralgia in nasopharyngeal carcinoma. J. Laryngol. Otol. 110:394‐396.
   Hutchins, L.G., Harnsberger, H.R., Hardin, C.W., Dillon, W.P., Smoker, W.R., and Osborn, A.G. 1989. The radiologic assessment of trigeminal neuropathy. AJR Am. J. Roentgenol. 153:1275‐1282.
   Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott‐Raven, Philadelphia.
   Yousem, D.M., Atlas, S.A., Grossman, R.I., Sergott, R.C., Savino, P.I., and Bosley, T.C. 1989. MR of Tolosa‐Hunt syndrome. Am. J. Neuroradiol. 10:1181‐1184.
   Yousem, D.M., Arrington, J.A., Kumar, A.J., Bryan, R.N. 1990a. Bright lesions on sellar/parasellar T1‐weighted scans. Clin. Imaging 14:99‐105.
   Yousem, D.M., Patrone, P.L., Grossman, R.I. 1990b. Leptomeningeal metastases: MR evaluation. J. Comput. Assist. Tomogr. 14:255‐261.
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