Head Position-Dependent Pulsatile Tinnitus due to Jugular Bulb Diverticulum

A 57-year-old woman presented with position-dependent pulsatile tinnitus in the right ear, worsening with contralateral head rotation and disappearing with ipsilateral neck compression. Temporal bone computed tomography (CT) revealed a right jugular bulb diverticulum with bony dehiscence, while CT and digital subtraction angiography demonstrated dynamic ipsilateral internal jugular vein compression worsening with contralateral head rotation, alongside contralateral transverse sinus agenesis. Symptoms resolved after sinus wall resurfacing. This case underscores the need to comprehensively evaluate coexisting venous abnormalities in pulsatile tinnitus.