Detection of an intracranial bruit by auscultation is usually regarded as an ominous portent of serious intracranial disease. This need not be the case. Though arteriovenous malformations, aneurysms, neoplasms, and excessive flow through normal vasculature are well-known causes of intracranial bruits, ectopic location of normal vessels should also be considered.1 One such variant is the high jugular bulb.
REPORT OF A CASE
A 42-year-old woman was referred to us for evaluation of worsening pulsatile tinnitus associated with a subjective and objective bruit in the left inframastoid region.The patient related a lifelong history of pulsatile tinnitus that waxed and waned. She had learned to obliterate the sound almost completely by applying pressure to the left jugular vein. Following a bout of acute labyrinthitis in the spring of 1981, she noted that the tinnitus had worsened. The sound at times was loud enough to prevent her from hearing conversation. Approximately
Beyer RA, McCarty GE. High Jugular Bulb and High Carotid Canal First Observed as Intracranial Bruit. Arch Neurol. 1983;40(6):387–388. doi:10.1001/archneur.1983.04050060087018
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