Fisch Staging of Jugular Foramen Schwannomas




Tumor confined to the soft tissue of the neck


Primary involvement of the neck with extension up to

the jugular foramen


Tumor fills the jugular foramen with resultant bone

expansion showing

Type C1 No involvement of the ICA above

the carotid foramen

Type C2 Involvement of the vertical segment

of the ICA

Type C3 Involvement of the horizontal segment

of the ICA

Type C4 Tumor extending into the foramen lacerum


Intracranial extension

Type De Extradural

Type Di Intradural

ICA, interior carotid artery.

ICA, interior carotid artery.

mon.4'52 These patients present with elements of jugular foramen syndrome (Vernet or Jackson syndrome).4'5 Symptoms tend to be of longer standing in those with tumors mainly involving the bone at the base of the skull, and shorter in those patients with entirely extracranial tumors.4 As these more distal lesions enlarge' symptoms and signs referable to a mass effect within the parapharyngeal space may develop.

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