The presence of a ganglion-like tumefaction is reported in the mediastinal course of the right vagus nerve at T1 level in a cadaver in the Universidad Industrial de Santander's morphology laboratory.The vagal ganglion was located next to hyperplasic lymphoid nodes in para-tracheal and tracheal-bronchial levels, agglomerating in a large lymphoid mass in the carina and the pulmonary hilum.Anatomical-pathological study revealed a marked, diffusely distributed, predominantly histo-lymphocyte mixed inflammation, separating the epineurium, producing lysis of the vagus nerve fibers.This finding showed the degeneration of this cranial par by mediastinal pathology.This provided a possible explanation for the physiopathology of pain referring to the head and neck in inflammatory or neoplastic pathology involving compression and degeneration by inflammatory infiltration of the vagus nerve.Pons-medullar trigeminal afferent tracts and connectivity, supra-spinal pathways for processing somatic-visceral pain, possible somatic-vegetative responses and the integration of the trigeminal system in the physiology of pain concerning the vagus nerve are all discussed.