High mega jugular bulb presenting with facial nerve palsy and severe headache

We present a rare case of a 50-year-old female patient with symptomatic high mega jugular bulb requiring surgery. We review her medical file, preoperative and postoperative imaging, audiograms, and surgical report. High jugular bulb was diagnosed with computed tomography and magnetic resonance imaging. Symptoms of facial nerve palsy and headache were abolished after surgical procedure. Headache and facial nerve palsy can be caused by high mega jugular bulb. Surgery is indicated in such symptomatic cases and leads to relief of signs and symptoms of disease.