Medicine:Jugular foramen syndrome

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Jugular foramen syndrome
Brain human normal inferior view with labels en-2.svg
Human brain inferior view showing cranial nerves

Jugular foramen syndrome, or Vernet's syndrome, is characterized by paresis of the glossopharyngeal, vagal, and accessory (with or without the hypoglossal) nerves.[1][2]

Symptoms

Symptoms of this syndrome are consequences of this paresis. As such, an affected patient may show:[citation needed]

  • dysphonia/hoarseness
  • soft palate dropping
  • deviation of the uvula towards the normal side
  • dysphagia
  • loss of sensory function from the posterior 1/3 of the tongue (CN IX)
  • decrease in the parotid gland secretion (CN IX)
  • loss of gag reflex
  • sternocleidomastoid and trapezius muscles paresis (CN XI)

Causes

  • Glomus tumors (most frequently)
  • Meningiomas
  • Schwannomas (Acoustic neuroma)
  • Metastatic tumors located at the cerebellopontine angle
  • Trauma
  • Fracture of occipital bone
  • Infections
  • Cholesteatoma (very rare)
  • Obstruction of the jugular foramen due to bone diseases
  • Nasopharyngeal carcinoma spreading into the parapharyngeal space involving the ninth, tenth, and eleventh cranial nerves

Diagnosis

  • Gadolinium enhanced mri for vestibular schwannoma
  • mri and biopsy for nasopharyngeal carcinoma
  • based on nerve palsies
  • NCCT for occipital bone fracture

References

  1. Erol FS, Kaplan M, Kavakli A, Ozveren MF.Jugular foramen syndrome caused by choleastatoma. Clin Neurol Neurosurg. 2005 Jun;107(4):342-6.
  2. Schmidek and Sweet Indications, Methods and Results (Expert Consult - Online and Print) (6th ed.). London: Elsevier Health Sciences. 2012. p. 2337. ISBN 9781455723287.