Unilateral pulsatile tinnitus

Objectives: To assess a non-invasive means of predicting a venous trans -stenotic pressure gradient (TPG) and intracranial pressure (ICP) as opposed to invasive examinations in unilateral venous pulsatile tinnitus (PT) patients. Methods: Thirty patients with unilateral venous PT who presented symptomatic-sided transverse sinus stenosis (TSS) on computed tomography venography (CTV), ipsilateral TPG measured by digital subtraction angiography (DSA) and cerebrospinal fluid (CSF) pressure measured by lumbar puncture were included...

Vestibular migraine (VM) is one of the most common types of episodic vertigo. Over the last 11 years, this disorder has been studied by both neurologists and otolaryngologists. Based on the clinical symptoms and previous migraine history, the Barany Society and the International Classification of Headache Disorders have created the diagnostic criteria for VM. Unilateral and pulsatile headache, phonophobia, photophobia, auras, and a previous history of migraine have been included in these criteria. Although these symptoms are common and widely known, other symptoms not included in the Barany Society criteria are emerging and have been described in some clinical studies...

OBJECTIVES: To characterize patterns of sensorineural hearing loss (SNHL) and tinnitus in patients with idiopathic intracranial hypertension (IIH). STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Adult patients diagnosed with IIH via lumbar puncture (LP) between 2010 and 2020 who had available audiograms. The study included a total of 40 patients; 33 women, and 7 men with a median age of 43...

BACKGROUND: Tinnitus is a common condition presenting to the ENT out-patient clinic. Vestibular schwannomas are benign cerebellopontine angle tumours that usually present with unilateral sensorineural hearing loss. Magnetic resonance imaging of the internal auditory meatus is the definitive investigation in their detection. The current recommendation is for unilateral tinnitus patients to undergo magnetic resonance imaging of the internal auditory meatus to exclude vestibular schwannoma...

PURPOSE: Together with the foramen ovale, the middle meningeal artery (MMA) looks like a high heel shoe print on axial time-of-flight magnetic resonance angiography (TOF-MRA) images, with the MMA resembling the heel. Cranial dural arteriovenous fistulas (DAVF) are often fed by the MMA, which can lead to an increase of signal intensity and diameter of this vessel, resulting in a more "shiny" and "thick" high heel print appearance than on the contralateral side. We describe this finding as a novel radiologic sign and provide cut-off values for the ratios of MMA signal intensities and diameters for predicting the presence of a DAVF...

Tinnitus is the sensation of hearing a sound in the absence of an internal or external source and is a common problem encountered in primary care. Most cases of tinnitus are benign and idiopathic and are strongly associated with sensorineural hearing loss. A standard workup begins with a targeted history and physical examination to identify treatable causes and associated symptoms that may improve with treatment. Less common but potentially dangerous causes such as vascular tumors and vestibular schwannoma should be ruled out...

Idiopathic intracranial hypertension (IIH) is a disorder of unknown etiology that results in isolated raised intracranial pressure. Classic symptoms and signs of IIH include headache, papilledema, diplopia from sixth nerve palsy and divergence insufficiency, and pulsatile tinnitus. Atypical presentations include: (1) highly asymmetric or even unilateral papilledema, and IIH without papilledema; (2) ocular motor disturbances from third nerve palsy, fourth nerve palsy, internuclear ophthalmoplegia, diffuse ophthalmoplegia, and skew deviation; (3) olfactory dysfunction; (4) trigeminal nerve dysfunction; (5) facial nerve dysfunction; (6) hearing loss and vestibular dysfunction; (7) lower cranial nerve dysfunction including deviated uvula, torticollis, and tongue weakness; (8) spontaneous skull base cerebrospinal fluid leak; and (9) seizures...

Background: Pulsatile tinnitus presents as a unique variation of tinnitus in which a conscious perception of the heartbeat is localized to the ears in either unilateral or bilateral fashion. The sensation is typically caused by an increase in turbulent blood flow in the affected ear, in most cases, due to a structural abnormality of the venous sinuses - the most common of which being stenosis. Herein, we discuss the etiology of pulsatile tinnitus followed by indications for treatment of various pathologies which have been successfully treated with venous sinus stenting and have led to resolution of auditory symptoms...

OBJECTIVES: Abnormal neuronal activity and functional connectivity have been reported in patients with venous pulsatile tinnitus (PT). As neuronal activity is closely coupled to regional brain perfusion, the purpose of this study was to investigate the cerebral blood flow (CBF) alterations in patients with unilateral venous PT using arterial spin labeling (ASL). METHODS: This study included patients with right-sided PT between January 2018 and July 2019. A healthy control (HC) group matched 1:1 for gender and age was also recruited...

Pulsatile tinnitus is an uncommon symptom characterized by a perceived sound pulsing like a heartbeat. Here, we report an unusual case of a patient with unilateral pulsatile tinnitus caused by a large, prominent mastoid emissary vein (MEV). A 45-year-old woman presented at our hospital with pulsatile tinnitus. She had persistent tinnitus for 20 years, and her symptoms had worsened in the previous 2 years. She said that she perceived a sound pulsing like a heartbeat. She had some hearing impairment in both the ears for a long time owing to long-term otitis media...

OBJECTIVE: To evaluate the prevalence, surgical management, and audiologic impact of pulsatile tinnitus caused by sigmoid sinus dehiscence. STUDY DESIGN AND SETTING: Retrospective chart review at a tertiary care hospital. PATIENTS: Adults with unilateral pulsatile tinnitus attributable to sigmoid sinus dehiscence who underwent resurfacing between January 2010 and January 2020. INTERVENTIONS: Transmastoid sigmoid resurfacing...

BACKGROUND AND PURPOSE: Aplastic or twig-like middle cerebral artery (MCA) is a rare vascular anomaly characterized by replacement of the M1 segment by a plexiform network of small vessels. Though rare, familiarity with this entity and ability to differentiate it from radiological mimics such as moyamoya changes and steno-occlusive diseases are important. We review the clinical and radiological manifestations of patients diagnosed with twig-like MCA on cerebral angiograms over a five-year period...

Purpose: To investigate cerebral blood flow (CBF) differences in patients with left- and right-sided pulsatile tinnitus (LPT and RPT) and healthy controls (HCs) to further explore the lateralization effects of PT using arterial spin labeling (ASL). Methods: ASL data from 21 RPT patients, 17 LPT patients and 21 HCs were reviewed. Voxel-wise analysis and region of interest analysis were performed to explore differences in CBF among the three groups. Tinnitus Handicap Inventory (THI) score and tinnitus duration were obtained from each patient...

Objective: To discuss the outcomes of the surgical treatment of venous pulsatile tinnitus caused by sigmoid sinus diverticulum. Method: Fifty-eight patients with venous pulsatile tinnitus caused by unilateral sigmoid sinus diverticulum were admitted. The patients' tinnitus was graded and treated by sigmoid sinus bone wall reconstruction. The maximum cross-sectional area of sigmoid sinus diverticulum defect was measured in 28 patientsc. All the patients were followed up for 3 to 44 months after operation to analyze the improvement of postoperative tinnitus, the relationship between the size of the sigmoid sinus cross-sectional area and the degree of tinnitus and length of disease statistically...

BACKGROUND: Pulsatile tinnitus is often a chronic and debilitating condition and normally has a vascular origin. We describe a case of pulsatile tinnitus due to an aberrant branch of the external carotid artery (ECA), which has not been reported previously. METHOD: A 67-year-old female with chronic unilateral pulsatile tinnitus, which could be controlled completely with direct pressure on a small tortuous superficial branch behind her left ear. This was confirmed with doppler to be an unusually tortuous occipital branch of the ECA...

BACKGROUND: Pulsatile tinnitus (PT) is a debilitating condition that can be caused by a vascular abnormality, such as an arterial or venous lesion. Although treatment of PT-related venous lesions has been shown to successfully cure patients of the associated 'tormenting' rhythmical sound, much controversy still exists regarding their role in the etiology of PT. METHODS: A patient presented with a history of worsening, unilateral PT. A partial venous sinus obstruction related to the large arachnoid granulation was detected on the right side, and subsequently stented at the right transverse sinus...

OBJECTIVES: To investigate the correlation between transverse sinus stenosis (TSS) and transstenotic pressure gradient (TPG) in unilateral pulsatile tinnitus (PT) patients with sigmoid sinus wall anomalies (SSWA). METHODS: Fifty-seven patients with unilateral venous PT were retrospectively included. All of them underwent CT venography and catheter manometry, accompanied with SSWA. The degree, length, shape (intrinsic/extrinsic/dysplasia), location (proximal/middle/distal, referring to the relative position of TSS and the Labbé vein junction) of TSS, the types of SSWA (dehiscence/diverticulum), and the degree of transverse sinus outflow laterality were assessed, and the correlations with ipsilesional TPG were analyzed...

PURPOSE: Idiopathic intracranial hypertension (IIH) is raised intracranial pressure without any identifiable etiology. The inner ear structures are susceptible to cerebrospinal fluid (CSF) pressure changes because of connections between the CSF space and the labyrinth to explain the audiovestibular symptoms, such as pulsatile tinnitus or dizziness, reported in 50% to 60% of these patients. The aim of this study was to investigate the vestibular functions using cervical vestibular evoked myogenic potentials (cVEMPs) in IIH...

PURPOSE: To investigate the relevant factors of unilateral pulsatile tinnitus (PT) in patients with idiopathic intracranial hypertension (IIH) using CT. METHODS: CT angiography images of IIH patients with unilateral PT (n = 19), without PT (n = 13), and controls (n = 32) were reviewed. The characteristics including transverse sinus stenosis (TSS), venous outflow laterality (VOL), sigmoid sinus wall dehiscence (SSWD), and sigmoid sinus diverticulum (SSD) were quantitatively or/and qualitatively detected...

BACKGROUND: Otosclerosis causes conductive, sensorineural and mixed hearing loss (CHL, SNHL, MHL) and tinnitus in young adults. It is best diagnosed on high-resolution CT (HRCT). Occasionally, patients presenting with SNHL and/or tinnitus may undergo temporal bone MRI as the first investigation. In this study, we have described the role of MRI as the first-line modality in the detection of previously undiagnosed otosclerosis. Using search words 'MRI otosclerosis' we found 15 cases in the PACS of our institute, (University Hospitals, KU Leuven, Belgium) from 2003 to 2018...