Masticator muscle enhancement in subacute denervation atrophy.

Atrophy of the muscles of mastication is a well known indirect sign of damage to the mandibular division of the trigeminal nerve (V3). Because V3 motor palsy is difficult to diagnose clinically, computed tomography (CT) or magnetic resonance (MR) imaging of the head and neck often provide the only evidence of masticator space muscle atrophy (1). This finding, in turn, should alert the physician to the possibility of head and neck neoplasm or brain stem abnormality. The imaging characteristics of denervation atrophy have been well described previously (1–3). We present a case of enhancement of atrophic muscles of mastication in a patient with a history of pontine hemorrhage.