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A Convenient Sonographic Technique for Diagnosis of Pulsatile Tinnitus Induced by a High Jugular Bulb

Department of Neurosurgery (M.N., K.F.) and Clinical Laboratory (N.M.), Kosei General Hospital, Hiroshima, Japan.

Address correspondence to Minoru Nakagawa, MD, Department of Neurosurgery, Kosei General Hospital, 3-3-28 Minami, Mihara, Hiroshima 723-8686, Japan. E-mail: ydhm18357{at}yahoo.co.jp

Objective. The purpose of this report is to describe our experience with sonography in a case of pulsatile tinnitus (PT) due to a high jugular bulb (HJB). Methods. A 71-year-old woman came to our hospital with a 1-year history of right PT. A right HJB was shown on cerebral angiography, and enlargement of the right jugular blub compared with the left side was found. First, the ultrasound probe was placed on the anterior right upper neck at the anterior edge of the sternocleidomastoid muscle to identify the ipsilateral internal jugular vein (IJV) and measure the flow velocity. After the measurement, the ultrasound probe gradually compressed the skin until the flow in the IJV decreased. Results. The patient reported that her PT decreased after the flow in the IJV decreased. We decided that the PT in this case was induced by the HJB. Conclusions. This technique is less invasive and convenient for the diagnosis of PT caused by an HJB.

Key Words: brain • high jugular bulb • pulsatile • sonography • tinnitus

Abbreviations: HJB, high jugular bulb • IJV, internal jugular vein • PT, pulsatile tinnitus