Asymmetrically large jugular bulb

Last revised by Dr Tim Luijkx on 22 Apr 2016

Asymmetrically large jugular bulbs are entirely normal and asymptomatic; its only significance is to distinguish it from pathology.

The size of the jugular bulbs is variable, with the right side being significantly larger than the left in two-thirds of people.

A normal but large bulb will have an intact jugular spine, normal bony margins and have proportionately large ipsilateral internal jugular vein and sigmoid sinus. Its dome will not extend above the floor of the internal acoustic meatus (IAM) thus distinguishing it from a high riding jugular bulb.

Due to turbulent flow in the jugular bulb, signal on MRI can be confusing, and it must not be mistaken for a tumor.

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Cases and figures

  • Case 1: right larger than left
    Drag here to reorder.