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Pulsatile tinnitus: A harbinger of a greater ill?
Author(s) -
Liess Benjamin D.,
Lollar Kevin W.,
Christiansen Sidney G.,
Vaslow Dale
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20851
Subject(s) - medicine , tinnitus , pulsatile flow , carotid artery dissection , dissection (medical) , magnetic resonance angiography , radiology , magnetic resonance imaging , internal carotid artery , surgery , cardiology , audiology
Background. Pulsatile tinnitus is an uncommon otologic symptom, which may be the presenting complaint of a potentially devastating pathology. Understanding this manifestation as a possible symptom of a significant vascular abnormality is crucial to guide management and treatment. Methods and Results. We describe a 38‐year‐old woman with sudden‐onset right‐sided pulsatile tinnitus. A right extracranial internal carotid artery (ICA) dissection was diagnosed with MRI/magnetic resonance angiography (MRA) and treated with anticoagulation. Follow‐up MRI/MRA demonstrated complete resolution. Two months later, left‐sided pulsatile tinnitus evolved. An MRI/MRA of the neck demonstrated left‐sided extracranial ICA dissection. She was treated in a similar fashion and a repeat MRI/MRA demonstrated its resolution. Conclusion. Spontaneous extracranial ICA dissection may present with pulsatile tinnitus as the only symptom in 4% to 50% of patients. Subsequent evolution of a contralateral dissection is even more uncommon. Generally, treatment of this phenomenon is conservative utilizing anticoagulation or aspirin; however, surgical intervention may be necessary. © 2008 Wiley Periodicals, Inc. Head Neck 2009