Trigeminal neuralgia is a debilitating condition with numerous etiologies. In this retrospective case series, we report a cohort of patients with a rarely described entity, absence of Meckel cave, and propose this as a rare cause of trigeminal neuralgia. A search of the electronic medical record was performed between 2000 and 2020 to identify MR imaging reports with terms including "Meckel’s cave" and "hypoplasia," "atresia," "collapse," or "asymmetry." Images were reviewed by 2 blinded, board-certified neuroradiologists. Seven cases of the absence of Meckel cave were identified. Seven patients (100%) had ipsilateral trigeminal neuralgia and ipsilateral trigeminal nerve atrophy, suggesting an association between absence of Meckel cave and trigeminal neuralgia. Absence of Meckel cave is a rare entity of unknown etiology, with few existing reports that suggest the possibility of an association with trigeminal neuralgia. Its recognition may have important implications in patient management. Future studies and longitudinal data are needed to assess treatment outcomes and added risks from surgical intervention in these patients.

三叉神经痛是一种具有多种病因的虚弱病症。在这个回顾性病例系列中，我们报告了一组很少被描述的实体，没有 Meckel 洞，并提出这是三叉神经痛的罕见原因。在 2000 年至 2020 年期间对电子病历进行了搜索，以识别包含“梅克尔洞穴”和“发育不全”、“闭锁”、“塌陷”或“不对称”等术语的 MR 成像报告。图像由 2 位盲法、董事会认证的神经放射科医生审查。确定了 7 个没有 Meckel 洞穴的案例。7 名患者 (100%) 患有同侧三叉神经痛和同侧三叉神经萎缩，表明没有 Meckel 腔与三叉神经痛之间存在关联。没有梅克尔洞穴是一种罕见的病因不明的实体，很少有现有报告表明可能与三叉神经痛有关。它的识别可能对患者管理具有重要意义。需要未来的研究和纵向数据来评估这些患者的治疗结果和手术干预的额外风险。