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- Title
Pulsatile tinnitus: A harbinger of a greater ill?
- Authors
Liess, Benjamin D.; Lollar, Kevin W.; Christiansen, Sidney G.; Vaslow, Dale
- Abstract
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
- Subjects
TINNITUS treatment; CAROTID artery surgery; MAGNETIC resonance imaging; PATHOLOGY; PATIENTS; DISEASES
- Publication
Head & Neck, 2009, Vol 31, Issue 2, p269
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.20851