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Jugular Foramen Syndrome


Presentation

  • Extramedullary plasmacytoma of the head and neck was discussed and its relation to cranial nerve dysfunction was reviewed, with presentation of an unusual case of plasmacytoma resulting in a variant of the jugular foramen syndrome.[ncbi.nlm.nih.gov]
  • Argoff, MD and Gary McCleane, MD who present a thorough update on the latest in pain management. Presents a new contemporary internal design that helps you navigate the text easier.[books.google.com]
Weight Loss
  • We report an elderly man who presents with dysphagia, dysarthria, hoarseness, and a 12-pound weight loss. Examination demonstrated paralysis of the right vagus and hypoglossal nerve.[ncbi.nlm.nih.gov]
  • PET and repeated head MRI scans were conducted two months later because of the patient’s severe weight loss, fatigue and headache. The PET scan showed the abnormal uptake of FDG in the right jugular foramen and both of the upper cervical nodes.[jstage.jst.go.jp]
Pathologist
  • At first a fleshless skele pensable: clinicians, radiologists, surgeons, radio therapists, and pathologists must all contribute their ton for global study, the body then appeared in slices, until with present techniques its smallest respective inputs[books.google.com]
Hoarseness
  • A 46-year-old male patient was evaluated for hoarseness. It was learnt from his anamnesis that he had been operated for otitis media nearly 20 years ago. Uvula deviated towards right. Loss of gag reflex was remarkable on the left.[ncbi.nlm.nih.gov]
  • 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 decrease in the parotid gland secretion loss[en.wikipedia.org]
  • […] carotid nerve tumor (primary form the nasopharynx or secondary from the uper cervical lymph nodes) symptoms : - pain in or behind ear due to irritation of the auricular branches of the 9 and 10 - headache due to irritation of the meningeal branch of 10 -hoarseness[cobocards.com]
Cough
  • Features depend on involved nerves: Symptions: Choking, dysphagia, speech changes, auditor canal pain, headache Features by nerve: IX: loss of gag reflex, sensation of the palate, auditor canal pain, glossopharyngeal neuralgia X: hoarse voice, weak cough[learningneurology.com]
  • He also noticed that he is coughing while eating food. There was no history of fever, trauma or ear discharge.[cancerjournal.net]
  • The larger, posterolateral, “pars vascularis” compartment contains CN X, CN XI, Arnold's nerve (or the auricular branch of CN X involved in the Arnold's reflex, where external auditory meatus stimulation causes cough), jugular bulb, and posterior meningeal[operativeneurosurgery.com]
  • Also, the cough reflex is partially mediated via general visceral afferent parasympathetic fibers. [4] The cough reflex is initiated by cough receptors.[ruralneuropractice.com]
  • For the jugular foramen lesions that expand to extracranial proportions these present with hoarseness, diminishing of the coughing reflex and reduction of the motor strength of the shoulder girdle, symptoms representing the typical jugular foramen syndrome[arquivosdeorl.org.br]
Aspiration
  • Computed tomographic (CT) guided needle aspiration confirmed metastatic melanoma. The onset of cranial neuropathy may allow the site of lesion to be predicted based on knowledge of the cranial base and neural anatomy.[ncbi.nlm.nih.gov]
  • CLINICAL MANIFESTATIONS Hoarseness and dysphagia with aspiration are the cardinal manifestations of JFS.[doctorabel.us]
  • Fine needle aspiration cytology from the left chest wall lesion showed features of small cell cancer of the lung. Although there was relief in the headache with high dose of opioid analgesics but the neurological deficits were persisting.[cancerjournal.net]
  • Damage to the motor division of the lower cranial nerves that run into the jugular foramen leads to hoarseness, dysphagia, and the risk of aspiration pneumonia; therefore, its functional preservation during surgical procedures is important.[operativeneurosurgery.com]
  • Vagus nerve lesion (X) Etiology Clinical features Loss of the gag reflex (efferent limb) Flaccid paralysis of the soft palate nasal speech and deviation of the uvula away from the lesion Epiglottic paralysis aspiration Dysphagia Features of vocal cord[amboss.com]
Hypophonia
  • The researchers studied a case of a 74-year-old man who presented with progressive dysphagia and dysarthria and was also found to have tongue deviation on the right side, left palatal droop and hypophonia.[healio.com]
Gagging
  • Loss of gag reflex was remarkable on the left. Paresis was found on the left vocal cord. There was weakness in rotation of the head to the right.[ncbi.nlm.nih.gov]
  • […] 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 decrease in the parotid gland secretion loss of gag[en.wikipedia.org]
  • . - 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 - decrease in the parotid gland secretion - loss of gag reflex - sternocleidomastoid[medicine.uiowa.edu]
  • Cerebellopontine Angle Syndrome Acoustic Tumours CN IX and CN VIII and CN V can be affected Symptoms: IX: Tinnitus Gag reflex decreased VIII: Vertigo Deafness V Facial Sensory defecit Jugular Foramen Syndrome (Vernet Syndrome) Glomus Jugular Tumours Base[en.wikibooks.org]
  • ’s syndrome Hypoglossal canal syndrome, Foramen magnum syndrome, Carotid canal syndrome Clinical features: Features depend on involved nerves: Symptions: Choking, dysphagia, speech changes, auditor canal pain, headache Features by nerve: IX: loss of gag[learningneurology.com]
Nausea
  • A small number of patients present primarily with a phaeochromocytoma-like picture - eg, perspiration, pallor, nausea, hypertension and tachycardia.[patient.info]
  • For 2 months, he complained of dizziness, nauseas, vomiting and frontal headache irradiated to the whole cranium. In this period, he presented with three episodes of the syncope.[arquivosdeorl.org.br]
  • Symptoms Patients may complain of earache, tenderness, fever, ear discharge, deep unilateral facial pain, headache, diplopia, dizziness, nausea, vomiting, and confusion [1] [13].[eyewiki.aao.org]
  • Other related symptoms include headache, perspiration, pallor, and nausea [ 13, 14 ]. The treatment of glomus jugulare tumors presents the surgeon with a significant management problem.[wjso.biomedcentral.com]
  • Other related symptoms include headache, perspiration, pallor, and nausea. [3] Otoscopic examination reveals a characteristic, pulsatile, reddish-blue tumor behind the tympanic membrane that is often the beginning of more extensive findings (ie, the tip[emedicine.medscape.com]
Vomiting
  • For 2 months, he complained of dizziness, nauseas, vomiting and frontal headache irradiated to the whole cranium. In this period, he presented with three episodes of the syncope.[arquivosdeorl.org.br]
  • Symptoms Patients may complain of earache, tenderness, fever, ear discharge, deep unilateral facial pain, headache, diplopia, dizziness, nausea, vomiting, and confusion [1] [13].[eyewiki.aao.org]
Choking
  • […] lacerocondylar area syndrome intercondylar space syndrome Retropharyngeal space syndrome Villaret’s syndrome Hypoglossal canal syndrome, Foramen magnum syndrome, Carotid canal syndrome Clinical features: Features depend on involved nerves: Symptions: Choking[learningneurology.com]
Progressive Dysphagia
  • The researchers studied a case of a 74-year-old man who presented with progressive dysphagia and dysarthria and was also found to have tongue deviation on the right side, left palatal droop and hypophonia.[healio.com]
Decreased Taste Sensation
  • Decreased taste sensation of the ipsilateral tongue and weakness of the ipsilateral trapezius and sternocleidomastoid muscles may be reported. Other manifestations such as PT and/or hearing loss are common in patients with glomus tumors.[doctorabel.us]
Drooling
  • Cranial nerve examination showed left sided facial droop with drooling of saliva, left sided sensorineural deafness, impaired gag reflex on left side and difficulty in swallowing (left seventh, eighth, ninth and tenth cranial nerve involvement).[cancerjournal.net]
Corneal Opacity
  • Neurologically, his higher mental functions were normal; fundus could not be checked because of bilateral corneal opacities.[cancerjournal.net]
Osteophyte
  • Despite their rarity, posterior cervical osteophytes can result in the development of jugular foramen syndrome, according to researchers.[healio.com]
Neck Weakness
  • In a case of Miller-Fisher-syndrome associated with Bickerstaff encephalitis, the patient presented with ophthalmoplegia, bilateral facial palsy, dysphagia, dysarthria, neck weakness, distal quadriparesis, and ataxia. [91] These abnormalities improved[ruralneuropractice.com]
Hypertrichosis
  • Cyclosporin-induced hypertrichosis (excess hair growth) in his external auditory canal contributed greatly to the initial difficulty in managing his otitis externa.[ncbi.nlm.nih.gov]
Flushing
  • In such cases, patients may experience headache, labile blood pressure, sweating, and flushing (43). Approximately 3% of glomus jugulare tumors are malignant and develop metastases.[doctorabel.us]
Cranial Nerve Involvement
  • Physical examination showed signs compatible with a right XI, X, and XI cranial nerves involvement and also several vesicular lesions in the right ear's concha. He had a personal history of poliomyelitis and chickenpox.[ncbi.nlm.nih.gov]
  • Cranial nerve examination showed left sided facial droop with drooling of saliva, left sided sensorineural deafness, impaired gag reflex on left side and difficulty in swallowing (left seventh, eighth, ninth and tenth cranial nerve involvement).[cancerjournal.net]
  • Cranial nerve involvement produces hoarseness and dysphagia.[wjso.biomedcentral.com]
  • Lower cranial nerve involvement as the initial manifestation of Lyme borreliosis. Neurologia 1999;14:36-7. 86. Hirabayashi K, Morikawa N, Mori H, Miyake T, Suda K, Kondo T, et al.[ruralneuropractice.com]
Nasal Speech
  • Vagus nerve lesion (X) Etiology Clinical features Loss of the gag reflex (efferent limb) Flaccid paralysis of the soft palate nasal speech and deviation of the uvula away from the lesion Epiglottic paralysis aspiration Dysphagia Features of vocal cord[amboss.com]
Apraxia
  • 在辩论中以犀利有力而有名的对手 She suffers from lockedin syndromea profound apraxia caused by brain damage that renders her body useless and her voice mute 她患有“锁闭综合症”,这是一种由于大脑受损引起的全面性的运动不能症,导致全身失去功能,嗓子无法发声。[hujiang.com]
Irritability
  • […] entrapemnt of any of the last four cranial nerves and or the neraby carotid nerve tumor (primary form the nasopharynx or secondary from the uper cervical lymph nodes) symptoms : - pain in or behind ear due to irritation of the auricular branches of the[cobocards.com]
Seizure
  • DETAILS OF AUTHORS’ CASES No Age/Sex Hospital stay Symptoms Signs Duration Diagnosis 1 28y/F 21 days Seizures, headache, deafness Lt ear& facial weakness & numbness Lt V1,2,3Lt.VII,VIII N palsy, Lt.[thamburaj.com]

Workup

  • The purpose of this section is to define this syndrome and elucidate the epidemiology, pathogenesis, clinical manifestations, diagnostic workup, and general treatment options for the syndrome.[doctorabel.us]
  • After diagnosis has been made additional investigations are required as part of the preoperative workup.[jnnp.bmj.com]
Candida
  • Following an initial successful treatment with prolonged intravenous antibiotics the patient relapsed with a secondary infection in the same anatomical site due to Candida parapsilosis.[ncbi.nlm.nih.gov]

Treatment

  • Early surgery is important to completely reverse the lost nerve functions in treatment.[ncbi.nlm.nih.gov]
  • […] inferior view showing cranial nerves Jugular foramen syndrome, or Vernet's syndrome, is characterized by the paresis of the glossopharyngeal, vagal, and accessory (with or without the hypoglossal ) nerves. [1] [2] Contents 1 Symptoms 2 Causes 3 Diagnosis 4 Treatment[en.wikipedia.org]
  • Progressing from fundamental principles through specific treatment strategies for the cancers of each organ system, it also addresses the effects of radiation on normal structures and the avoidance of complications.[books.google.com]

Prognosis

  • […] multiple swelling all over the body and the patient had painful enlargement that he perceived as an ongoing process of the von Recklinghausen's disease and made a delay in seeking the medical advice resulting in a well advanced disease and with poor prognosis[cancerjournal.net]
  • Retropharyngeal lymph nodes [ edit ] It is not clear whether these are staged as N0 or N1, with differences among institutions Prognosis for RLN N0 appears comparable to N1 RLNs atrophy with age, and are usually obliterated by adulthood.[en.wikibooks.org]
  • Prognosis Glomus jugulare tumours tend to grow slowly with only a small proportion metastasising. The associated cranial nerve palsies tend to be more cosmetic than debilitating.[patient.info]
  • Among the three tumors that commonly arise in the JF, meningiomas have the worst prognosis for postoperative cra-nial nerve function and recurrence. Glomus Jugulare Tumors Most tumors arising primarily in the JF are glomus jugulare tumors.[slideshare.net]
  • […] posterior communicating artery aneurysm ) Pupillary sparing often due to ischemic microangiopathy Treatment Compressive lesions: surgery Ischemic microangiopathy or demyelinating lesions: medical management with adequate control of the underlying disease Prognosis[amboss.com]

Etiology

  • While trauma, vascular disease, and infection may be etiologic, most cases result from malignancies, usually metastatic. We have described a case of metastatic adenocarcinoma of the prostate resulting in the Collet-Sicard variant of this syndrome.[ncbi.nlm.nih.gov]
  • TREATMENT Treatment must be directed toward the primary etiology.[doctorabel.us]
  • Vocal Fold Paralysis (Vocal Cord Paralysis) Etiologies Vocal Cord Paralysis Evaluation and Etiology see also: Collett-Sicard Syndrome Jugular Foramen Syndrome Affected Cranial Nerves Collet-Sicard syndrome IX,X,XI,XII Villaret syndrome IX,X,XI,XII sympathetic[medicine.uiowa.edu]
  • Tanaka M, Hirai S, Okamoto K, Morimatsu M, Yamaguchi H (1987) Benign and idiopathic jugular foramen syndrome-an etiological consideration. Clin Neurol (Tokyo) 27:329–333 Google Scholar Copyright information Authors and Affiliations H. Sawada 1 F.[link.springer.com]
  • Etiology Clinical features Extorsion of the eye : inability to depress and adduct the eyeball simultaneously (the pupil shoots upward during attempted adduction of the eyeball) Diplopia ( double vision ) Mild esotropia Trigeminal nerve lesion (V) Etiology[amboss.com]

Epidemiology

  • The purpose of this section is to define this syndrome and elucidate the epidemiology, pathogenesis, clinical manifestations, diagnostic workup, and general treatment options for the syndrome.[doctorabel.us]
  • Epidemiology [ 1 ] The annual incidence is about 1 in 1.3 million people per year. However, it is the most common tumour of the middle ear and the second most common tumour of the temporal bone.[patient.info]
  • From Wikibooks, open books for an open world Jump to navigation Jump to search Nasopharyngeal Cancer Overview Epidemiology [ edit ] Markedly different geographical prevalence Rare in the US: 0.2-0.5 cases per 100,000 people Common in China, Hong Kong[en.wikibooks.org]
  • Epidemiology Glomus tumors occur with an estimated annual incidence of 1 case per 1.3 million people. [16] Although rare, glomus tumors are the most common tumor of the middle ear and are second to vestibular schwannoma as the most common tumor of the[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology, 25(1), 1-35. ‎ Pagina 52 - In: Wall PD, Melzack R (eds), Textbook of pain. Churchill Livingstone, Edinburgh... ‎[books.google.it]
  • PATHOGENESIS Mass effect on neural contents of the jugular foramen from various neoplastic, vascular, infectious, and inflammatory processes is the main pathophysiologic mechanism of this syndrome.[doctorabel.us]
  • Pathophysiology Bacteria travels from the middle ear to the mastoid air cells, which contain highly vascular marrow and are susceptible to infection [5].[eyewiki.aao.org]
  • Pathophysiology The glomera jugulare, or glomus bodies, are small collections of paraganglionic tissue.[emedicine.medscape.com]
  • Pathophysiology, diagnostics and therapy of chronic cough: Neuronal reflexes and antitussiva. Pneumologie 2013;67:327-34. 5. Samandari F, Resßig D. Functional anatomy of cranial nerves and the vegetative nervous system.[ruralneuropractice.com]

Prevention

  • Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. ‎ Pagina 74 - Heim, C".., Ehlert, U., & Hellhammer, DH (2000). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders.[books.google.it]
  • Watertight closure with grafts, packing of the cavity with fat, and use of vascularized muscle flap are used to prevent CSF leak and its complications.[thamburaj.com]
  • Intraoperative mapping and monitoring of the motor rootlets at the cerebellomedullary cistern using endotracheal tube electrodes is a safe and effective procedure to prevent its injury. see jugular foramen stenosis.[operativeneurosurgery.com]
  • Primary prevention The administration of antibiotics upon diagnosis of otitis media helps prevent the progression to GS. [9].[eyewiki.aao.org]
  • The indications for surgery include associated deep space neck infections, carotid sheath involvement (to prevent extension into the carotid artery), intra-luminal abscess and failed medical treatment.[ispub.com]

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