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# Jugular foramen

The jugular foramen is an opening between the temporal and occipital bones; it carries cranial nerves IX, X and XI and drains blood into the jugular vein.

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## What it is

An opening between the temporal and occipital bones.

## What it does

Carries nerves IX, X and XI and drains the brain into the internal jugular vein.

## Key points

- Jugular foramen (Vernet) syndrome, IX, X and XI on one side: weak gag and lost taste on the back of the [tongue](https://durgical.com/en/anatomy/tongue/), hoarseness and swallowing trouble, uvula pulled to the healthy side, weak shrug
- Glomus jugulare tumour (jugular paraganglioma): pulsatile tinnitus in time with the heartbeat, hearing loss and a red mass behind the [eardrum](https://durgical.com/en/anatomy/tympanic-membrane/), later palsies of the nerves in the foramen
- Often split into a smaller front part (IX, inferior petrosal sinus) and a larger back part (X, XI, sigmoid sinus becoming the internal jugular vein); texts differ on the compartments

## Key facts

**Where**
Between the petrous temporal and occipital bones

**Function**
Transmits IX, X, XI, the internal jugular vein (from the sigmoid sinus) and inferior petrosal sinus

## Relations

**Contents**
Glossopharyngeal (IX), vagus (X) and accessory (XI) nerves; the [sigmoid sinus](https://durgical.com/en/anatomy/sigmoid-sinus/) widening into the jugular bulb and [internal jugular vein](https://durgical.com/en/anatomy/internal-jugular-vein/); the inferior petrosal sinus; meningeal branches of the ascending pharyngeal and occipital arteries

**In front**
[Carotid canal](https://durgical.com/en/anatomy/carotid-canal/), separated by a thin ridge of bone, where the [internal carotid artery](https://durgical.com/en/anatomy/internal-carotid-artery/) enters the skull

**Medial**
[Hypoglossal canal](https://durgical.com/en/anatomy/hypoglossal-canal/), below and medial, with the [hypoglossal nerve (XII)](https://durgical.com/en/anatomy/hypoglossal-nerve/); the occipital condyle

**Lateral**
Styloid process and [stylomastoid foramen](https://durgical.com/en/anatomy/stylomastoid-foramen/), where the [facial nerve](https://durgical.com/en/anatomy/facial-nerve/) leaves the skull

**Above**
Floor of the middle ear (tympanic cavity) over the jugular bulb; the [internal acoustic meatus](https://durgical.com/en/anatomy/internal-acoustic-meatus/) above and in front

**Behind**
Groove of the sigmoid sinus, curving down to it from the [transverse sinus](https://durgical.com/en/anatomy/transverse-sinus/)

## How to find it

It cannot be felt. From below, it is the large irregular opening between the petrous temporal and occipital bones, behind the carotid canal and medial to the styloid process. Inside the skull it lies at the lower end of the sigmoid sinus groove, in the posterior cranial fossa.

## Examination

- Gag reflex and palate: a weak gag on one side and the uvula pulled toward the healthy side point to IX and X
- Voice and swallow: a breathy, hoarse voice from a paralysed [vocal fold](https://durgical.com/en/anatomy/vocal-fold/) (X), confirmed by laryngoscopy
- Shrug and head turn against resistance: a weak shrug on the same side and weak turning of the head away from it point to XI

## On imaging

CT with bone windows shows its size and margins: a glomus tumour erodes them irregularly, a schwannoma widens them smoothly. MRI shows the salt-and-pepper look of larger paragangliomas; MR or CT venography separates slow flow in a large jugular bulb from thrombosis.

## Clinical notes

- High or dehiscent jugular bulb: the bulb rises into the floor of the middle ear, sometimes through a gap in the bone, and shows as a blue mass behind the eardrum; a hazard in ear surgery and not to be taken for a tumour
- Causes of jugular foramen syndrome include paragangliomas, schwannomas, meningiomas, metastases, skull base fractures and infection
- Clot can spread from the sigmoid sinus into the internal jugular vein after mastoid infection

## Anatomical variants

- The right foramen is usually larger than the left, because the right sinuses usually drain more blood
- A bony bridge between its two edges can divide it into separate compartments

## Test yourself

Think of the answer, then tap the question to see it.

## Which nerves and veins pass through the jugular foramen?

The glossopharyngeal (IX), vagus (X) and accessory (XI) nerves; the sigmoid sinus becoming the internal jugular vein; the inferior petrosal sinus.

## What are the signs of jugular foramen (Vernet) syndrome?

Weak gag, lost taste on the back of the tongue, hoarseness, swallowing trouble, uvula pulled to the healthy side and weak shrug (IX, X, XI).

## How does a glomus jugulare tumour at the jugular foramen present?

Pulsatile tinnitus in time with the heartbeat, hearing loss and a red mass behind the eardrum, later palsies of the nerves in the foramen.

## What does a blue mass behind the eardrum suggest near the jugular foramen?

A high or dehiscent jugular bulb; a hazard in ear surgery and not to be taken for a tumour.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
foramen jugulare TA2 458

**Official Spanish (DeCS)**
Agujero yugular

**English (TA2)**
Jugular foramen

## Related

- [Sigmoid sinus](https://durgical.com/en/anatomy/sigmoid-sinus/)
- [Internal jugular vein](https://durgical.com/en/anatomy/internal-jugular-vein/)
- [Glossopharyngeal nerve (IX)](https://durgical.com/en/anatomy/glossopharyngeal-nerve/)
- [Vagus nerve](https://durgical.com/en/anatomy/vagus-nerve/)
- [Accessory nerve (XI)](https://durgical.com/en/anatomy/accessory-nerve/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Head and Neck: Jugular Foramen](https://www.ncbi.nlm.nih.gov/books/NBK538507/); [Jugular Foramen Syndrome](https://www.ncbi.nlm.nih.gov/books/NBK549871/).

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Source: https://durgical.com/en/anatomy/jugular-foramen/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/jugular-foramen/
