The exact process underlying the development of trigeminal neuralgia (TN) is not yet fully clarified, with multiple factors potentially contributing to the condition. MRI is a valuable tool in identifying the possible causes. This paper reviews the anatomy of the trigeminal nerve associated with TN, describes the imaging features of vascular compression in TN patients, and examines the correlation between these findings and the TN branch affected. A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The search terms used were ((neurovascular conflict) AND (trigeminal nerve)) AND (neuralgia). Databases such as ResearchGate, ScienceDirect, Google Scholar, and PubMed/Medline were searched. The initial search yielded 3,886 articles, and after applying selection criteria, 4 articles were selected for the analysis. The methodological quality of non-randomized studies was assessed using the MINORS tool. The combination of the second and third trigeminal nerve branches was the most commonly affected, occurring in 55.6% of cases. The comparison between the second and third branches and the most common vessels involved in neurovascular conflict showed no significant statistical difference. MRI remains the primary diagnostic method for detecting NVC in TN. The studies reviewed indicate that the vertebral artery and superior cerebellar artery are the most commonly implicated vessels in NVC. Further research with larger sample sizes is necessary to create an algorithm that can identify the vessel causing compression in TN affecting specific branches.
