Sigmoid sinus diverticulum is a rare vascular finding due to an opening in the bone at the area of the sigmoid sinus creating a pouch, or diverticulum. Sometimes, there may be associated stenosis. The diverticulum may present as pulsatile tinnitus. Several case reports have demonstrated that treatment or endovascular coiling of this diverticulum can provide relief for a patients' symptoms. 


Sigmoid sinus diverticulum can be diagnosed either by CT, CTA, MRI or MRV. Cerebral angiography provides definitive diagnosis

Sigmoid Sinus Diverticulum

Axial CT: Right sigmoid sinus diverticulum

Sigmoid Sinus Diverticulum

Venogram, showing right sigmoid sinus diverticulum

Sigmoid Sinus Diverticulum

Venogram, after coiling of the pouch, the diverticulum is closed


If no other source is found for the patient's symptoms of pulsatile tinnitus, treatment of the diverticulum via endovascular coiling, if found on the same side of the patient's symptoms, can provide relief in reducing or eliminating this sound. 


1. Srinivasan Paramasivam, Sunil Furtado, Tomoyoshi Shigamatsu, Eric Smouha. Endovascular Management of Sigmoid Sinus DiverticulumInterv Neurol. 2016 Jun; 5(1-2): 76–80.