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A Convenient Sonographic Technique for Diagnosis of Pulsatile Tinnitus Induced by a High Jugular Bulb
Author(s) -
Nakagawa Minoru,
Miyachi Norimitsu,
Fujiwara Kenjiro
Publication year - 2008
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2008.27.1.139
Subject(s) - medicine , tinnitus , internal jugular vein , sternocleidomastoid muscle , jugular vein , ultrasound , valsalva maneuver , radiology , anatomy , surgery , audiology , blood pressure
Objective The purpose of this report is to describe our experience with sonography in a case of pulsatile tinnitus (PT) due to a high jugular bulb (HJB). Methods A 71‐year‐old woman came to our hospital with a 1‐year history of right PT. A right HJB was shown on cerebral angiography, and enlargement of the right jugular blub compared with the left side was found. First, the ultrasound probe was placed on the anterior right upper neck at the anterior edge of the sternocleidomastoid muscle to identify the ipsilateral internal jugular vein (IJV) and measure the flow velocity. After the measurement, the ultrasound probe gradually compressed the skin until the flow in the IJV decreased. Results The patient reported that her PT decreased after the flow in the IJV decreased. We decided that the PT in this case was induced by the HJB.A right HJB (arrow) and enlargement of the right jugular bulb compared with the left side are shown on angiography.The right IJV is interrogated with B‐mode sonography (arrow). The flow curve of the right IJV is taken by spectral Doppler sonography (arrowhead). The decrease in the flow in the IJV obtained by compression of the IJV is shown on spectral Doppler sonography (asterisk).Conclusions This technique is less invasive and convenient for the diagnosis of PT caused by an HJB.