Presentation
Presents full-color images throughout to match the images that you see in practice. Extensive use of "combination" imaging presents a complete picture of how to more precisely locate and target the radiotherapy field. [books.google.com]
VAGAL PARAGANGLIOMA PRESENTING AS JUGULAR FORAMEN SYNDROME Abstract This paper presents a case of paraganglioma in-volving the vagus nerve presenting as jugular fo-ramen syndrome. [ejournal-tnmgrmu.ac.in]
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]
Metastatic lung cancer presenting with jugular foramen syndrome in a case of von Recklinghausens disease. J Can Res Ther 2010;6:391-3 How to cite this URL: Agarwal A, Baisakhiya N, Kakani A, Bhake A, Nagrale M, Reddy S. [cancerjournal.net]
Entire Body System
- Swelling
A 57-year-old gentleman had multiple gradually increasing swellings over the body since many years. [cancerjournal.net]
Uncomplicated cases present with pain and swelling in the neck, and a cord can be palpated beneath the sternocleidomastoid muscle. [ispub.com]
Fundoscopy revealed bilateral optic disc swelling. He underwent an urgent magnetic resonance imaging (MRI) scan; however, no significant pathology was evident. A neurological opinion was sought and the patient underwent a lumbar puncture. [nature.com]
The presence of proptosis, with swelling of eyelids and chemosis (swelling of ocular surface membranes), indicates significant mass extension within the orbit. [jnnp.bmj.com]
[…] cerebellar signs. 1yr Lt.8thnerve residual schwanoma. 3 56y/F 15 days Tinnitus Lt ear, pain in the neck, vertigo, facial weakness Lt.5,7,8,10,11nerve palsy with cerebellar signs 6mths Lt.8th nerve schwanoma 4 58y/M 31 days Right ear pain, right neck swelling [thamburaj.com]
- Falling
The audiometry showed normal right auditory thresholds with a fall to 8 kHz and left mixed severe hearing loss. [arquivosdeorl.org.br]
The method used in that study, however, still falls short of exact quantification of venous outflow pathways. [ajnr.org]
- Asymptomatic
This may be asymptomatic but can also form cysts. [5] Cholesterol granuloma occurs when red blood cells and other tissue break down, releasing cholesterol to form crystals that induce an inflammatory response. [eyewiki.aao.org]
Respiratoric
- 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]
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]
He also noticed that he is coughing while eating food. There was no history of fever, trauma or ear discharge. [cancerjournal.net]
Over the next two days the patient continued to spike high temperatures and developed a productive cough. Chest X-ray revealed an abscess and infiltrate in the right lung. [ispub.com]
Gastrointestinal
- Dysphagia
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]
The syndrome is therefore characterised by: loss of taste to posterior 1/3 of tongue (CN IX) dysphagia (CN X) sternocleidomastoid and trapezius paralysis (CN XI) Anything that compresses the jugular foramen can cause this syndrome. [mrcpandme.blogspot.com]
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]
[…] 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 due to paralysis of the laryngeal nerves - dysphagia [cobocards.com]
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]
’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]
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]
[…] 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]
- 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]
Musculoskeletal
- Fracture
[…] parotid gland secretion loss of gag reflex sternocleidomastoid and trapezius muscles paresis Causes [ edit ] Glomus tumors (most frequently) Meningiomas Schwannomas ( Acoustic neuroma ) Metastatic tumors located at the cerebellopontine angle Trauma Fracture [en.wikipedia.org]
[…] skull base syndromes including jugular foramen syndrome: Intracranial: Neoplastic: Extension of cerebellopontine angle tumour Meningioma Cholesteotoma Neurofibroma Guillain-Barre syndrome & variants Chronic tuburculosis Syphilis Diabetes mellitus Skull: Fractured [learningneurology.com]
[…] case of occipital condyle fractures. [57], [58] Ipsilateral [59] or contralateral [60] hypoglossal nerve palsy is the most frequent isolated LCN injury from condyle fractures. [ruralneuropractice.com]
He sustained severe facial trauma, including multiple lacerations and facial bone fractures. The man is taken to the operating room by the ENT team, who attempt to reconstruct his facial bones with multiple plates and screws. [medbullets.com]
Usually they are associated with costal fractures (as shown in most of our cases), as well as large hematoma on the thoracic and abdominal wall (Not present in any of our cases). We describe 7 cases of pulmonary hernia. [posterng.netkey.at]
Psychiatrical
- Aggressive Behavior
behavior and likelihood of recurrence.13 Review of the published series’ and reports reveals the meningothelial (WHO grade I) variant to be the most common. [slideshare.net]
Neurologic
- Cranial Neuropathy
The jugular foramen (Vernet) syndrome with neuropathy of cranial nerves IX-XI is more commonly due to metastatic lesions than primary neoplasms. [ncbi.nlm.nih.gov]
These tumors may also present with pulsatile tinnitus as well as multiple lower cranial neuropathies, including jugular foramen syndrome (paralysis of cranial nerves IX, X, and XI), Collet-Sicard syndrome (paralysis of cranial nerves IX, X, XI, and XII [radiology.uthscsa.edu]
Article Title: Jugular foramen syndrome as initial presentation of metastatic lung cancer Abstract: Metastatic involvement of the cranial base and jugular foramen generally presents with headache and lower cranial neuropathy but may escape early diagnosis [discover.luc.edu]
Tuberculosis is one of the differential diagnoses that should be considered in patients with multiple cranial neuropathies with few clinical findings. [jstage.jst.go.jp]
Multiple cranial neuropathies are common, particularly in lesions arising from tumors, trauma, impaired blood flow, and infections. [amboss.com]
- Paresis
Unilateral paresis of 9th-11th cranial nerves together is defined as jugular foramen (Vernet's) syndrome. [ncbi.nlm.nih.gov]
vagal, and accessory (with or without the hypoglossal ) nerves. [1] [2] Contents 1 Symptoms 2 Causes 3 Diagnosis 4 Treatment 5 References Symptoms [ edit ] Symptoms of this syndrome are consequences of this paresis. [en.wikipedia.org]
A diversity of lesions have been shown to be involve in the jugular foramen, such as tumors, vascular lesions, infections, and trauma SYMPTOMS Symptoms of this syndrome are consequences of paresis of the above mentioned cranial nerves (9, 10, 11). - dysphonia [medicine.uiowa.edu]
If the jugular foramen syndrome develops (paresis of cranial nerves IX to XI), there may also be complaints of hoarseness and symptoms associated with dysphagia. [patient.info]
The most common neurological deficit was IX, X, XI cranial nerve paresis in 7 patients, sensorineural deterioration in hearing, facial paresis, XII cranial nerve paresis and trigeminal impairment were also recorded. [wjso.biomedcentral.com]
- 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]
Involvement of the inner ear produces vertigo and sensorineural hearing loss [ 11 ]. Cranial nerve involvement produces hoarseness and dysphagia. [wjso.biomedcentral.com]
More rarely, cranial nerves are involved in hereditary neuropathy. [ruralneuropractice.com]
Involvement of the inner ear produces vertigo and sensorineural hearing loss. Cranial nerve involvement produces hoarseness and dysphagia. [emedicine.medscape.com]
- Dysarthria
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]
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]
Thus, symptoms of LCN lesions include dysphagia, dysarthria, hoarse voice, chocking during ingestion of fluids, taste disturbances (posterior third of tongue), sensory disturbances (posterior third of the tongue, soft palate, throat, external auditory [ruralneuropractice.com]
Guillain-Ba rré syndrome Any cranial nerve ; most commonly III, VII, IX, X Autoimmune inflammation of peripheral cranial nerves Facial droop ( CN VII ) Dysarthria and dysphagia ( CN IX and X ) Ophthalmoplegia and diplopia ( CN III ) Multiple sclerosis [amboss.com]
The patients with IX, X and XI cranial nerves dysfunction may present with dysphagia, dysarthria, hoarseness of voice, dystphonia, nasal regurgitation, ipsilateral trapezius and sternomastoid muscle weakness and atrophy, depressed gag reflex, palatal [thamburaj.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 [amboss.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]
Treatment
Early surgery is important to completely reverse the lost nerve functions in treatment. [ncbi.nlm.nih.gov]
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]
[…] 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]
Prognosis
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]
[…] 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]
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]
[…] 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]
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]
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]
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]
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]
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]
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]
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]
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]
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]