Jugular bulb diverticulum

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  • Congenital vascular abnormality of jugular bulb
  • Focal finger like projection extending from jugular bulb into surrounding skull base
  • Commonly seen with high riding jugular bulb
  • Extends superiorly and medially, into area between IAC, posterior cranial fossa and bony vestibular aqueduct
  • Asymptomatic, incidental finding
  • Symptoms if present: sensorineural hearing loss, tinnitus, vertigo, Meniere disease
  • Conservative management
  • Commonly extends superiorly 
  • High riding jugular bulb
  • Diverticulum < 1 cm in diameter and length
  • Lobulated out pouching
  • Finger like or broad based
  • Uniform post contest enhancement (similar to jugular bulb) with contiguity demonstrated to jugular bulb