Remember what is in the jugular foramen?

J Vet Intern Med. 2025

Megan Madden 1, Theofanis Liatis 2, Cesar Llanos 2, Sumari Dancer 1, Patricia Alvarez 3, Sarah Tayler 2, Alexandros Hardas 4, Steven De Decker 2

Background
Jugular foramen syndrome (JFS) is characterized by deficits of cranial nerves IX, X, and XI due to lesions at the jugular foramen. In veterinary medicine, it is rarely reported and poorly understood. This retrospective case series aimed to describe the clinical presentation, diagnostic imaging findings, and outcomes of dogs diagnosed with JFS using MRI and CT.

Methods
Ten dogs with confirmed JFS based on clinical signs and imaging findings were reviewed. Clinical signs, neurologic deficits, imaging data, and outcomes were assessed. Diagnosis required evidence of cranial nerve dysfunction (IX, X, XI) and a lesion affecting the jugular foramen region on advanced imaging. Histopathology was available in some cases.

Results
Common clinical signs included dysphonia, dysphagia, tongue atrophy, and aspiration pneumonia. MRI and CT revealed mass lesions (e.g., neoplasia), inflammatory changes, or structural abnormalities at the jugular foramen in all cases. Lesions were unilateral in most dogs. Outcomes varied: five dogs were euthanized due to poor prognosis or severe aspiration pneumonia, while others were managed medically or surgically with variable improvement.

Limitations
This small case series lacks long-term follow-up in several cases. Histopathologic confirmation was not available for all diagnoses, and therapeutic approaches were not standardized. The rarity of JFS in dogs limits generalizability.

Conclusions
JFS in dogs presents with a consistent cluster of clinical signs linked to lower cranial nerve dysfunction. Advanced imaging is essential for diagnosis. Prognosis is guarded, particularly in cases with severe aspiration pneumonia or aggressive neoplasia. Early recognition may facilitate intervention and improve outcomes.

Confirmed mixed/transitional grade 1 meningioma (Case 8). Magnetic resonance imaging study of the head at the level of the tympanic bullae. Transverse 3D T1W spoiled Gradient Echo pre-contrast (A), post-contrast (B), subtraction (C), and 2D T2W-FLAIR TSE (D). Single, ovoid, extra-axial, homogeneous contrast-enhancing mass causing widening of the JF (B; arrowhead), tympano-occipital fissure (C; arrow) and indentation of the dorsal margin of the tympanic bulla (B; arrow). The mass is producing moderate mass effect and mild perilesional vasogenic edema (D: Arrowhead).

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