Journal of Neurology

, Volume 245, Issue 3, pp 137–142 | Cite as

Pulsatile tinnitus —a review of 84 patients

  • Daniel Waldvogel
  • Heinrich P. Mattle
  • Matthias Sturzenegger
  • Gerhard Schroth
Original Communications

Abstract

Pulsatile tinnitus can be annoying for a patient and can also be the only clue to a potentially devastating and life-threatening disease. In order to understand its clinical spectrum and management better we analysed the files of 84 patients seen at our institution over a 10-year period. Noninvasive techniques (ultrasound, computed tomography, magnetic resonance imaging) and angiography were employed as investigations tailored to the individual patient. A vascular disorder [i.e. arteriovenous fistula, dissection of the internal carotid artery (ICA), fibromuscular dysplasia, aneurysm of the ICA and sinus thrombosis] was found in 36 patients (42%), most commonly a durai arteriovenous fistula or a carotid-cavernous sinus fistula. In 26 patients with a vascular abnormality, pulsatile tinnitus was the presenting symptom. In 12 patients (14%), nonvascular disorders such as glomus tumour or intracranial hypertension with a variety of causes explained the tinnitus. We conclude that patients with pulsatile tinnitus should be investigated with noninvasive techniques. If these are negative or to clarify abnormal findings of noninvasive techniques selective angiography is needed for diagnosis and to guide treatment

Key words

Tinnitus, pulsatile Differential diagnosis Vascular diseases Glomus tumour Angiography 

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Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • Daniel Waldvogel
    • 1
  • Heinrich P. Mattle
    • 1
  • Matthias Sturzenegger
    • 1
  • Gerhard Schroth
    • 2
  1. 1.Department of NeurologyInselspitalBernSwitzerland
  2. 2.Department of NeuroradiologyUniversity of Bern, InselspitalBernSwitzerland

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