Fig. 9
From: The pterygopalatine fossa: imaging anatomy, communications, and pathology revisited
a Perineural spread of infection along the maxillary division (V2) of the right trigeminal nerve caused by E. coli infection of the right maxillary sinus in a 47-year-old female, who presented with fever and hypoesthesia along the right V2 dermatome. Axial contrast-enhanced FS T1W MR image shows right maxillary sinusitis involvement of the right PPF (thick arrow), PMF (dotted arrow), and the skin and subcutaneous tissue (thin arrow) overlying the right maxillary region. Thickening and abnormal enhancement of the right ION (arrowhead) due to perineural spread of infection is evident, thus resulting in hypoesthesia along the right V2 dermatome. b Coronal contrast-enhanced FS T1W MR image of the same patient shows asymmetrical thickening and abnormal enhancement of the right ION (solid arrow) secondary to perineural spread of infection from the PPF. Note the normal left ION (dotted arrow). c Coronal contrast-enhanced FS T1W MR image of the same patient shows abnormal enhancement with increased vascularization of the right PPF (arrows) due to its infective involvement by the right maxillary sinusitis. The contralateral PPF (asterisk) shows a normal appearance