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Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
The glossopharyngeal nerve emerges from the posterior lateral sulcus of the medulla in line with the vagus and the bulbar fibers of the spinal accessory nerve and enters the internal part of the jugular foramen lying on the medial side of the sigmoid sinus. The foramen angles forward and laterally under the petrous bone, which is excavated by the slight ballooning of the sigmoid sinus as the sinus exits through the skull to become the jugular bulb. The glossopharyngeal, vagus, and accessory nerves exit anterior to the jugular bulb from the jugular foramen.
Abnormal Skull
Published in Swati Goyal, Neuroradiology, 2020
It is a mixed nerve with motor (most of the soft palate, superior and recurrent laryngeal nerves), special (taste from the epiglottis), sensory (ear, larynx, viscera), and parasympathetic (regions of the head/neck, thorax, and abdominal viscera) functions. It leaves the skull through the jugular foramen (pars vascularis)
Neurological Disease of the Pharynx
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Nasopharyngeal carcinomas and particularly skull-base tumours compress and invade the lower cranial nerves producing a variety of symptoms. MRI and CT scanning of the anterior cranial fossa, brain and temporal bone should follow the appropriate clinical examination. Surgery or radiotherapy can then be considered. A variety of jugular foramen syndromes exist, described in Table 54.1. A small number of paraneoplastic syndromes have been associated with neurogenic dysphagia including squamous cell carcinoma of the skin, transitional cell carcinoma of the bladder, ovarian cancer, prostate cancer and chronic lymphocytic leukaemia.9–13
Clinical characteristics of petrosal cholesteatoma and value of MRI-DWI in the diagnosis
Published in Acta Oto-Laryngologica, 2020
Wenjing Zuo, Fangyuan Wang, Shiming Yang, Dongyi Han, Pu Dai, Weidong Shen, Zhaohui Hou, Weiju Han
Among the 81 cases, there were 2 cases of inconsistency between admission diagnosis and discharge diagnosis. One case was diagnosed as jugular foramen occupation in hospital, and pathology was cholesteatoma at discharge. The other case was diagnosed as facial schwannoma in hospital, and pathologically diagnosed as cholesteatoma of the petrosal region of temporal bone at discharge. We also analyzed the causes of misdiagnosis: 1. the specificity of CT alone and conventional MRI sequence was poor; 2. the clinical manifestations were atypical. Facial schwannoma is characterized by facial nerve deformity and enlargement of facial nerve bone canal on CT, accompanied by mastoid airway obstructive lesions, low signal on T1WI, equal signal on T2WI, and high signal on cystic lesions. Contrast enhancement showed obvious enhancement, and diffusion was not limited on DWI imaging. The ‘salt and pepper sign’ can be seen in jugular foramen occupation tumors, and the enhanced imaging has obvious enhancement. Therefore, in general, facial schwannoma and jugular foramen tumors can be differentiated from petrous cholesteatoma by CT and conventional MRI sequence, but some cases have not found typical imaging features, so we need to add MRI-DWI sequence to differentiate them [17].
MRI-guided definition of cerebrospinal fluid distribution around cranial and sacral nerves: implications for brain tumors and craniospinal irradiation
Published in Acta Oncologica, 2019
Amber M. Wood, Maarten H. Lequin, Marielle M. Philippens, Enrica Seravalli, Sabine L. Plasschaert, Marry M. van den Heuvel-Eibrink, Geert O. Janssens
CSF distribution was only observed in the dural sheaths surrounding the optic (II), trigeminal (V), facial (VII), vestibulo-cochlear (VIII), glossopharyngeal (IX), vagus (X), accessory (XI) and hypoglossal nerves (XII). For the optic nerves the CSF extended up to the posterior aspect of the eyeball in all scans, mean extension 40 mm (95% CI 38–42; Figure 1(A)). Mean extension of the CSF around n. V, was 16 mm (95% CI 15–19; Figure 1(B)). CSF in the internal acoustic canal, encompassing n. VII and n. VIII, was observed up to a mean distance of 11 mm (95% CI 11–12; Figure 1(C)). In the jugular foramen, where the n. IX, n. X and n. XI are located, the mean CSF flow beyond the inner table of the skull is 7 mm (95% CI 7–9; Figure 1(D)). CSF around the n. XII was visible in 8 out of the 20 MRI-images only and was observed at a mean distance of 8 mm (95% CI 7–9; Figure 1(E)). A summary per cranial nerve is given in Table 1.
Anatomic Alert: Spinal accessory nerve traversing a fenestrated internal jugular vein
Published in British Journal of Neurosurgery, 2019
Jay I. Kumar, Shunchang Ma, Pankaj Agarwalla, Nir Shimony, Shih S. Liu
This abnormality was noted during an educational prosection of the jugular foramen. Three cadaveric heads were dissected bilaterally to demonstrate the anatomy of the jugular foramen and the relationship of adjacent neurovascular structures, including the internal jugular vein, the transverse process of the C1 vertebra, the rectus capitis lateralis, and CNXI.