Jugular bulb diverticulum

• 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

Imaging 

• 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