Jugular foramen syndrome

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]

Jugular foramen syndrome
Human brain(normal) inferior view showing cranial nerves

Symptoms

Symptoms of this syndrome are consequences of this paresis. As such, in an affected patient, you may find:

• 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. Quinones-Hinojosa, Alfredo, ed. (2012). Schmidek and Sweet Indications, Methods and Results (Expert Consult - Online and Print) (6th ed.). London: Elsevier Health Sciences. p. 2337. ISBN 9781455723287.