The Jugular Foramen: Microsurgical Anatomy and Operative Approaches

Abstract

The jugular foramen, based on these studies of microsurgical anatomy, is divided into three compartments: two venous and a neural or intrajugular compartment. The venous compartments consist of a larger posterolateral venous channel, the sigmoid part, which receives the flow of the sigmoid sinus, and a smaller anteromedial venous channel, the petrosal part, which receives the drainage of the inferior petrosal sinus. The petrosal part forms a characteristic venous confluens by also receiving tributaries from the hypoglossal canal, petroclival fissure, and vertebral venous plexus. The petrosal part empties into the sigmoid part through an opening in the medial wall of the jugular bulb between the glossopharyngeal nerve anteriorly and the vagus and accessory nerves posteriorly. The intrajugular or neural part, through which the glossopharyngeal, vagus, and accessory nerves course, is located between the sigmoid and petrosal parts at the site of the intrajugular processes of the temporal and occipital bones, which are joined by a fibrous or osseous bridge. The glossopharyngeal, vagus, and accessory nerves penetrate the dura on the medial margin of the intrajugular process of the temporal bone to reach the medial wall of the internal jugular vein. The operative approaches, which access the foramen and adjacent areas and are demonstrated in a stepwise manner, are the postauricular transtemporal, retrosigmoid, extreme lateral transcondylar, and preauricular subtemporal-infratemporal approaches.

Arteriovenous Fistula Involving the Inferior Petroclival Vein -Case Report-

“…The IPCV courses along the extracranial or inferior surface of the petroclival fissure and is a mirror image of the IPS, which courses along the intracranial or superior surface of the fissure. 2,3) Angiographic and CT findings in the present case indicated that the AVF was located at the left IPCV.…”

“…The IPCV communicates with the ACC caudally and the cavernous sinus through the internal carotid artery venous plexus cranially. 2,3,6) Therefore, if an AVF occurs at the IPCV, both may form drainage routes. In the present case, the venous drainage descended into the ACC only (Fig.…”

“…The anatomical or clinical importance of an inferior petroclival or petrooccipital vein, which courses along the extracranial surface of the petroclival or petrooccipital fissure, is rarely discussed, 2,3) and vascular lesions involving the inferior petroclival vein (IPCV) have not been reported. We treated a patient with an arteriovenous fistula (AVF) involving the IPCV manifesting as ocular symptoms.…”

Micro-neurosurgical excision of dumbbell shaped very large jugular foramen schwannoma

“…Katsuta et al 27 split up the JF region in three portions: one nervous (intrajugular) and two venous; the cranial nerves IXth, Xth and XIth are in the nervous portion localized between the two venous. Finally, it should be considered that there are many anatomical variations in the course of neurovascular structures in this region and that they do not always respect and conform to the compartmentalization into different portions (pars nervosa and pars venosa) 28 .…”

An Unusual Anatomic Variation of the Jugular Foramen with Doubled Posterior Condylar Canal

“…However, Shapiro (1972) also described a third compartment containing the inferior petrosal sinus, which was located at the most medial portion of the JF. Recently, Katsuta et al (1997) redefined the compartments of the JF and classified the petrosal part, intrajugular part, and sigmoid part according to the structures which passed through the JF. The intrajugular or neural part through which the glossopharyngeal, vagus and accessory nerves run was located between the sigmoid and petrosal parts at the region of the intrajugular processes of the temporal and occipital bones.…”