Glomus Jugulare

            These tumors arise from paraganglia along the auricular branch of the vagus nerve (nerve of Arnold) in the jugular fossa. They are benign but locally invasive lesions that slowly erode into adjacent areas of the skull base and posterior fossa. Most patients present with pulsatile tinnitus or neurological deficits secondary to involvement of cranial nerves 9, 10 and 11. Multiple tumors occur in about 10% of cases.

            Paragangliomas have a unique MR appearance related to their extreme hypervascularity. Serpiginous areas of signal void from blood flow are interspersed among areas of flow-related enhancement and more isointense tumor cells. On T2-weighted images, they are of variable signal intensity but usually hyperintense to the surrounding muscles. MR angiography is helpful in determining involvement of the carotid artery and jugular vein. CT is better for showing subtle bone erosions. Endnote  

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