Jugular Bulb Diverticulum

Findings:

There is a moderate-sized superiorly projecting diverticulum of the left jugular bulb. The left vestibular aqueduct has an anomalous course extending into the left jugular diverticulum. The margin between this diverticulum and the intracranial compartment is markedly thin. The left sigmoid sinus groove is relatively deep but there is no definite dehiscence with the mastoid air cells in this region

Discussion/Differential Diagnosis:

Venous diverticula along the course of the dural sinuses are rare and symptomatology varies with the position and size. These are often asymptomatic if small, but may cause tinnitus or vertigo if large and/or dehiscent. A sigmoid sinus diverticulum with absent bone margin with relation to mastoid air cells may cause pulsatile tinnitus. In this case, the patient complains of vertigo and this is nearly certainly related to focal dehiscence of the vestibular aqueduct in the region of the diverticulum. A venous diverticulum causing dehiscence of the vestibular aqueduct is exceedingly rare.

This case was prepared with the assistance of Joshua Hall, UC undergraduate

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