High riding jugular bulb: prevalence and significance in asymptomatic children

Background: High riding jugular bulb (HJB) is a vascular abnormality characterized by the higher-than-normal location of the jugular bulb. Purpose: To evaluate the frequency of HJB among children who underwent cranial computed tomography (CT) mostly because of head trauma. Material and Methods: Patient demographics such as age, sex, indication of cranial CT, diameters of the right and left JB, and presence and laterality of HJB were recorded and analyzed. Patients were grouped as with HJB and without HJB; the variables were compared between these two groups. Patients were also divided into age groups as 0–1 month, 1–12 months, 12–24 months, and >24 months and the findings. The Shapiro–Wilk test, histograms, and Q-Q, Mann–Whitney U-test, Pearson's chi-square test, and Fisher's exact test were used. Results: In total, CT images of 194 patients (388 JBs) were evaluated. Overall, 42.8% of children had HJB. Only three children had bilateral HJB. Of all JBs, 22.2% were high riding. Children who did not have HJB were significantly younger compared to children with HJB (P = 0.029). The median diameter of the HJB was significantly higher in children with HJB compared to children without HJB on both sides (P < 0.001). Among newborns, none had HJB. In infants, 11 (30.6%) had HJB; 35 (46.7%) and 37 (50.0%) children aged >12–24 months and >24 months had HJB, respectively. Conclusion: A jugular bulb could be identified in all age groups, including newborns. The earliest age of HJB detection was eight months. Overall, 42% of the patients had HJB, which increased by age.