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Cranial nerves Flashcards

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1
Q

What are the identification of cranial nerves?

A
  1. Diameter
  2. Course
  3. Vessels
  4. CSF
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2
Q

What is cranial nerve III?

A

Oculomotor nerve

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3
Q

What is cranial nerve IV?

A

Trochlear nerve

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4
Q

What is cranial nerve V?

A

Trigeminal nerve

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5
Q

What is cranial nerve VI?

A

Abducens nerve

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6
Q

What are the segments of CN?

A
  1. Central (nuclei, central fascicles)
  2. cisternal (brainstem > dura)
  3. Cavernous sinus (SOF) - intraforaminal/intracanalicular
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7
Q

What can cisternal segments be visualised with? 1.5T

A
  1. 2D-SE/FSE/TSE
  2. 3D-CISS (Siemens)
  3. 3D-FSE/TSE
  4. 3D-FASE (Toshiba)
  5. FIESTA (GE)
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8
Q

What is CISS?

A

assessment of the anatomical variations and various pathologies involving the cranial nerves and central nervous system

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9
Q

What can cisternal segments be visualised with? 3.0T

A 
3D-CISS (Siemens)
SPACE (Siemens) 
FIESTA-C (GE)
CUBE (GE)
Balanced fast-field echo [b-FFE] (Philips)
VISTA (Philips)
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10
Q

What are the features of CISS?

A
  1. Steady-state-gradient-echo sequence
  2. Flow compensated
  3. MR cisternography
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11
Q

What are the 3D set of data for CISS?

A
  1. Reconstructions in any desired plane
  2. Slice orientation - course of cranial nerves
  3. 0.7 (0.5) mm slice thickness
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12
Q

What are examples of big cranial nerves?

A
  1. Optic nerve
  2. Trigeminal nerve
  3. Oculomotor nerve
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13
Q

What are the percentages that can be observed for the big cranial nerves on T2w TSE and 3D-CISS?

A

Optic nerve;
T2-w TSE: 100%
3D-CISS: 100%

Trigeminal nerve:
T2-w TSE: 100%
3D-CISS: 100%

Oculomotor nerve:
T2-w TSE: 82.5%
3D-CISS: 100%

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14
Q

What are examples of the small cranial nerves?

A

Abducent nerve
Hypoglossal nerve
Trochlear nerve

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15
Q

What are the percentages that can be observed for the small cranial nerves on T2w TSE and 3D-CISS

A

Abducent nerve:
T2-w TSE: 32.5%
3D-CISS: 100%

Hypoglossal nerve:
T2-w TSE: 10%
3D-CISS: 100%

Trochlear nerve:
T2-w TSE: 7.5%
3D-CISS: 47.5%

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16
Q

Big CN: CN II, CN III, CN V (sensory)

A

3D-CISS = conventional 2D TSE

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17
Q

Small CN: CN IV, CN VI, CN XII

A

3D-CISS&raquo_space; conventional 2D TSE

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18
Q

Trochlear nerve

A

3D-CISS: limitations

Technique has to be optimised

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19
Q

What sequences are intracanalicular and intraforaminal segment sensitive to with contrast?

A 
T1w 
	3D-TOF (MRA) + CM 
	3D-MPRAGE (Siemens) + CM 
	3D-GRASS (GE) + CM
	3D-SPGR (GE) + CM
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20
Q

What is the nucleus of oculomotor nerve?

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A

Tegmentum of mesencephalon

superior colliculi

Diametr 2.5-3mm

21
Q

Where is the trochlear nerve located?

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A

Caudal mesencephalon beneath the cerebral aqueduct

22
Q

What are the nucleus of trochlear nerve?

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A
  1. Tegmentum of mesencephalon

2. Inferior colliculi

23
Q

Where does the decussation of central fascicles occur for the trochlear nerve?

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A

Superior medullary velum

24
Q

What are the problems of cisternal segments?

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A 
Smallest CN				0.2-1 mm 
Longest intracranial course 	60 mm
Longest cisternal segment 	15-20 mm 
Differentiation from 	SCA branches
						small veins joining 					petrosal vein
“Hidden” between two folds of tentorium
Subtentorial segment
25
What are the initial cisternal segments?
A) Short segment close to the brainstem > Quadrigeminal cistern B) Long segment far from brainstem 2. Subtentorial segment > Ambient cistern
26
What is CN IV (trochlear nerve) identification?
3D-CISS + 3D-TOF ± CM
27
What are the landmarks for trochlear nerve?
1. Inferior colliculi | 2. Superior medullary velum
28
What is velum?
Very thin sheet covering the aqueduct
29
What are the segments for abducent nerve (CN VI)?
1. Nucleus: Floor of 4th ventricle 2. Pontomedullary sulcus 3. Prepontine cisterne 4. Dorello's canal 5. Cavernous sinus (SOF) 6. Orbita (lateral straight muscle) Diameter: 2.2 mm
30
What are the landmark for Abducent nerve?
1. Facial colliculus 2. Dorello's canal 3. Length of CSF invagination < 1-3mm
31
What is found within cavernous sinus?
3rd, 4th , part of 5th nerve and 6th nerve
32
What are frontal eye field?
Region located in the frontal cortex Responsible for saccadic eye movement for the purpose of visual field perception and awareness
33
What is Trigeminal ganglion?
Sensory ganglion of trigeminal nerve that occupies a cavity in the dura mater, covering the trigeminal impression near apex of petrous part of temporal bone
34
What is the identification for trigeminal ganglion?
3D-CISS + CM
35
How is facial nerve located?
Anteriorly
36
How is cochlear nerve located?
Superior and Inferior
37
What is the function of the vestibulocochlear nerve (CN VIII)?
1. Information comes from cochlea 2. Vestibular nuclei 3. Relay station 4. Up to the cortex
38
What are the components of Hypoglossal nerve?
1. Premedullary cistern (3-6 rootlets) 2. Hypoglossal canal (1-2 truncs) 3. Extracranial segments (1 trunc)
39
What are the lower cranial nerve complex?
CN IX-XI 1. Glossopharyngeal N (CN IX) 2. Vagus N (CN X) 3. Accessory N (CN XI)
40
What is located in CN VII?
chorda tympani & greater petrosal nerves
41
What is located in CN IX?
lingual branch
42
What is located in CN X?
superior laryngeal branch
43
How is CNVII located?
Rostral
44
Hhow is CN X located?
Caudal
45
What is the identification for hypoglossal canal?
3D-CISS + CM 3D-MPRAGE + CM
46
How can all cisternal segments of all CN be visualised?
in vivo at 1.5 T
47
Cranial nerve techniques
Location of nuclei Course of cisternal segments Exit through dura Neurovascular contacts
48
Optimised MRI technique
Cisternal S; Meckel‘s cave > 3D-CISS Intraforaminal/ intracanalicular S; Cavernous Sinus >> 3D-CISS / 3D-TOF / 3D-MPRAGE + CM Trigeminal ganglion > 3D-CISS / 3D-TOF + CM Neurovascular contacts ; CN IV > 3D-CISS + 3D-TOF ± CM

C1 Modules (20 decks)

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