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 inferior view showing cranial nerves

Symptoms

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

• dysphonia/hoarseness
• soft palate drooping
• 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