A 55-year-old woman presents with hoarseness, dysphagia, ipsilateral loss of the gag reflex, and weakness of trapezius and sternocleidomastoid on the same side. MRI shows a mass at the skull base. Which foramen is most likely involved?

• A Foramen ovale
• B Jugular foramen ✓
• C Internal acoustic meatus
• D Foramen spinosum

Explanation

This is Vernet's syndrome, the jugular foramen syndrome, involving cranial nerves IX, X and XI together. The glossopharyngeal, vagus and accessory nerves all leave the skull through the jugular foramen, so a tumor here produces loss of gag reflex, vocal cord paralysis with hoarseness, and sternocleidomastoid plus trapezius weakness. The internal acoustic meatus carries VII and VIII, and foramen ovale carries only the mandibular division of the trigeminal.

Reference: Snell's Clinical Anatomy by Regions, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.