Abstract
Introduction
Tinnitus is a symptom commonly associated with idiopathic intracranial hypertension (IIH) that can have a profound effect on quality of life. We aim to determine tinnitus symptom response after dural venous sinus stenting (DVSS) or CSF diversion with a shunt, in patients with both pulsatile (PT) and non-pulsatile tinnitus (NPT).
Methods
Single-centre cohort of IIH patients (2006–2016) who underwent 24-h ICP monitoring (ICPM). An un-paired t test compared ICP and pulse amplitude (PA) values in IIH patients with PT vs. NPT.
Results
We identified 59 patients with IIH (56 F:3 M), mean age 32.5 ± 9.49 years, 14 of whom suffered from tinnitus. Of these 14, seven reported PT and seven reported NPT. Patients with tinnitus had a mean 24-h ICP and PA of 9.09 ± 5.25 mmHg and 6.05 ± 1.07 mmHg respectively. All 7 patients with PT showed symptom improvement or resolution after DVSS (n = 4), secondary DVSS (n = 2) or shunting (n = 1). In contrast, of the 7 with NPT, only 1 improved post intervention (DVSS), despite 2 patients having shunts and 5 having DVSS.
Conclusions
NPT and PT were equally as common in our group of IIH patients. DVSS appears to be an effective management option for IIH patients with a clear history of pulsatile tinnitus. However, non-pulsatile tinnitus was more persistent and did not respond well to either DVSS or CSF diversion.
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Acknowledgements
We thank Dr Alexander Smedley and Dr Debayan Dasgupta for collating the data on ICP measurements.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All patients provided informed consent for 24-h ICPM, as part of their clinical management.
Conflict of interest
L D Watkins has received honoraria from and served on advisory boards for Medtronic, Codman and B Braun. Portions of this work were presented in abstract form at the Hydrocephalus 2017 conference of the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, Kobe, Japan, 23rd September 2017.
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Jonathan P. Funnell and Claudia L. Craven are equal contributors.
This article is part of the Topical Collection on CSF Circulation
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Funnell, J.P., Craven, C.L., Thompson, S.D. et al. Pulsatile versus non-pulsatile tinnitus in idiopathic intracranial hypertension. Acta Neurochir 160, 2025–2029 (2018). https://doi.org/10.1007/s00701-018-3587-8
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DOI: https://doi.org/10.1007/s00701-018-3587-8