Jugular foramen
Exit foramen · CN IX CN X CN XI
A large irregular opening between the petrous temporal and occipital bones in the posterior cranial fossa. IX leaves through the anteromedial part with the inferior petrosal sinus; X, XI and the internal jugular vein (the continuation of the sigmoid sinus) pass through the larger posterolateral part with the posterior meningeal artery. The hypoglossal canal lies just anteromedial, so large lesions add XII.
Traced from the start
Detail
- Transmits
- Glossopharyngeal (IX), vagus (X), accessory (XI), internal jugular vein from the sigmoid sinus, inferior petrosal sinus, posterior meningeal artery
- Neighbours
- Hypoglossal canal (XII) anteromedially, carotid canal anteriorly, foramen magnum posteromedially
- Below the foramen
- IX, X and XI run between the internal carotid artery and the internal jugular vein with XII before dispersing
When it goes wrong
Jugular foramen syndrome (Vernet syndrome) from a glomus jugulare paraganglioma, schwannoma, meningioma, nasopharyngeal carcinoma, skull base metastasis, osteomyelitis or fracture
Ipsilateral loss of the gag reflex and posterior-tongue taste (IX), palatal weakness with the uvula deviating away, hoarseness and dysphagia (X), and weak head-turning and shoulder shrug with wasting of sternocleidomastoid and trapezius (XI)
The same lesion extending to the hypoglossal canal (Collet–Sicard syndrome)
Vernet's triad plus tongue deviation towards the lesion with wasting and fasciculation
Glomus jugulare tumour eroding into the middle ear
Pulsatile tinnitus and a reddish-blue mass behind the eardrum before the lower cranial nerve palsies appear
Practise this structure
4 questions in the bank tagged Cranial Nerves.
A 52-year-old woman has had two months of numbness over the right forehead, the right upper eyelid and the tip of her nose, with a gritty feeling in the right e…
Foundations · middle twist
A 44-year-old man has had 18 months of worsening hearing on the left with constant ringing in that ear. He still follows conversation in a quiet room but cannot…
Foundations · middle twist
A 58-year-old man has sudden vertigo and a hoarse voice, and chokes when he drinks. The palate elevates to the right and there is no gag response when the left…
Foundations · middle twist
A 27-year-old man was struck on the head at football a week ago. He now sees two images, one above the other, worst when reading or going down stairs. The verti…
Foundations · middle twist