title: New treatment of vertigo caused by jugular bulb abnormalities.
abstract: OBJECTIVE
  Jugular bulb abnormalities can induce tinnitus, hearing loss, or vertigo. Vertigo can be very disabling and may need surgical treatments with risk of hearing loss, major bleeding or facial palsy. Hence, we have developed a new treatment for vertigo caused by jugular bulb anomalies, using an endovascular technique.
  
  
  METHODS
  Three patients presented with severe vertigos mostly induced by high venous pressure. One patient showed downbeat vertical nystagmus during the Valsalva maneuver. The temporal-bone computed tomography scan showed a high rising jugular bulb or a jugular bulb diverticulum with dehiscence and compression of the vestibular aqueduct in all cases.
  
  
  METHODS
  We plugged the upper part of the bulb with coils, and we used a stent to maintain the coils and preserving the venous permeability.
  
  
  RESULTS
  After 12- to 24-month follow-up, those patients experienced no more vertigo, allowing return to work. The 3-month arteriographs showed good permeability of the sigmoid sinus and jugular bulb through the stent, with complete obstruction of the upper part of the bulb in all cases.
  
  
  CONCLUSIONS
  Disabling vertigo induced by jugular bulb abnormalities can be effectively treated by an endovascular technique. This technique is minimally invasive with a probable greater benefit/risk ratio compare with surgery.
authors.affiliation: CHU de Caen, Caen, France Normandie University, Normandy, France UCBN, COMETE, Caen, France INSERM, U 1075 COMETE, Caen, France Department of Pharmacology & Toxicology, and Brain Health Research Center, University of Otago, Dunedin, New Zealand mart1_hit@yahoo.fr.
authors.forename: Martin
authors.initials: M
authors.lastname: Hitier
authors.affiliation: CHU de Caen, Caen, France Normandie University, Normandy, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Barbier
authors.affiliation: CHU de Caen, Caen, France.
authors.forename: Thenint
authors.initials: T
authors.lastname: Marie-Aude
authors.affiliation: CHU de Caen, Caen, France Normandie University, Normandy, France UCBN, COMETE, Caen, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Moreau
authors.affiliation: CHU de Caen, Caen, France Normandie University, Normandy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Courtheoux
authors.affiliation: CHU de Caen, Caen, France INSERM, U 1075 COMETE, Caen, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Patron
mesh_terms: D000328:Adult; D057510:Endovascular Procedures / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014717:Vertigo / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D014723:Vestibular Aqueduct / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult
keywords: coils; downbeat nystagmus; endovascular; jugular bulb; neurotology; stent; vertigo