Obligatory medical device diagnostics.
- Magnetic resonance imaging of the skull (cranial MRI) with contrast medium and fine layering of the brainstem (high-resolution MRI with 3D (T2) and CISS sequences), if necessary with MR angiography (imaging of blood vessels by contrast medium), the latter may be useful if neurovascular decompression is sought – Cranial MRI: in the initial diagnosis to exclude secondary forms of trigeminal neuralgia (eg. E.g. plaques in multiple sclerosis or tumors in the entry zone of the trigeminal nerve in the brain stem)Note: Imaging diagnosis of the entire neurocranium (part of the skull enclosing the brain) is essential!
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification of atypical headache or other accompanying symptoms.
- Computed tomography of the skull (cranial CT, cranial CT or cCT) – for suspected hemorrhage or bony lesions (injuries).
- Angio-CT (radiological examination procedure in which the blood vessels are examined with the aid of computed tomography (CT)) or angio-MRI (radiological examination procedure in which the blood vessels are examined with the aid of magnetic resonance imaging (MRI)) – if sinus vein thrombosis (SVT; occlusion of a cerebral sinus (large venous blood vessels of the brain arising from duraduplications) by a thrombus (blood clot)) is suspected.
- Digital subtraction angiography (DSA; procedure for isolated imaging of vessels) – in cases of suspected aneurysms (arterial dilation) or vasculitides (diseases in which autoimmunological processes lead to inflammation of arteries, arterioles, and capillaries)
- Encephalogram (EEG; recording of the electrical activity of the brain) – if seizures are suspected.
- X-rays of the cervical spine – if vertebragene (spinal) cause of the headache is suspected.
- X-rays of the paranasal sinuses or computed tomography (CT; sectional imaging method (X-rays from different directions with computer-based evaluation)) of the paranasal sinuses – if sinusitis (sinusitis) is suspected.
- Neurophysiological examinations – if neuritis (inflammation of the nerves) is suspected.
- Doppler/duplex sonography (ultrasound examination: combination of a sonographic cross-sectional image (B-scan) and the Doppler sonography method; imaging method in medicine that can dynamically represent fluid flows (especially blood flow)) – if dissection (splitting of vessel wall layers) is suspected.
- Quantitative sensory testing (QST; standardized clinical sensitivity testing with calibrated stimuli to investigate sensory abnormalities in patients suffering from neuropathic pain)
