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Pulsatile tinnitus —a review of 84 patients

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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

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Authors and Affiliations

  1. Department of Neurology, Inselspital, CH-3010, Bern, Switzerland

    Daniel Waldvogel, Heinrich P. Mattle & Matthias Sturzenegger

  2. Department of Neuroradiology, University of Bern, Inselspital, Bern, Switzerland

    Gerhard Schroth

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  1. Daniel Waldvogel
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  2. Heinrich P. Mattle
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  3. Matthias Sturzenegger
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  4. Gerhard Schroth
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Correspondence to Heinrich P. Mattle.

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Waldvogel, D., Mattle, H.P., Sturzenegger, M. et al. Pulsatile tinnitus —a review of 84 patients. J Neurol 245, 137–142 (1998). https://doi.org/10.1007/s004150050193

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  • DOI: https://doi.org/10.1007/s004150050193

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