Many people experience occasional ringing or buzzing in their ears. These sounds typically fade away within a few minutes, leaving no cause for concern. However, when the sound is a rhythmic whooshing pattern in sync with the heartbeat, it may serve as a warning sign that there is an underlying issue. This distinct symptom is known as pulsatile tinnitus.
What is pulsatile tinnitus?
Pulsatile tinnitus is an auditory experience, characterized by a rhythmic whooshing sound that aligns with the heartbeat. Unlike regular tinnitus, pulsatile tinnitus is linked to specific underlying causes associated with the brain and blood vessels.
Causes of pulsatile tinnitus
Pulsatile tinnitus can be attributed to various brain and blood vessel issues. However, identifying the precise source of the sound can sometimes be challenging. Potential causes include:
- Abnormal connections between arteries and veins known as fistulas
- Brain aneurysms and the narrowing of the carotid artery in the neck, a condition known as carotid stenosis
- Idiopathic intracranial hypertension (IIH), characterized by elevated pressure in the brain, particularly affecting obese women of childbearing age
While not all cases of pulsatile tinnitus have dangerous underlying causes, some individuals still experience a significant impact on their quality of life due to the debilitating sound.
Diagnosing pulsatile tinnitus
To determine the presence of pulsatile tinnitus, a comprehensive evaluation is necessary. This typically includes:
- A physical examination
- Review of medical history
- Non-invasive imaging tests to assess the brain and blood vessels
If a dangerous cause is suspected, a diagnostic cerebral angiogram may be recommended, involving the injection of contrast dye to visualize the blood vessels. This procedure helps measure pressures in the brain and identify potential narrowing or abnormalities that could contribute to pulsatile tinnitus.
Treatment for pulsatile tinnitus
Treatment options depend on the underlying cause. If the cause isn’t dangerous and the sound doesn’t bother the individual, they can continue their daily lives without worry. However, when it’s determined that the cause of pulsatile tinnitus is serious or the sound negatively affects their quality of life, neuro-interventional techniques such as stenting or embolization can be employed to address venous issues or abnormal connections between blood vessels. Ongoing research aims to enhance diagnostic capabilities and treatment options.