Pulsatile tinnitus

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Background

Etiologies

  • Arterial
    • Stenosis (9-18%): includes atherosclerotic plaques, the most common cause in the elderly, and fibromuscular dysplasia
    • Aneurysm (1-4%), particularly of the internal carotid artery
    • Anatomical variant (1-4%)
  • Arteriovenous transition
    • Dural arteriovenous fistula (7-8%)
    • Direct arteriovenous fistula (2-3%)
    • Arteriovenous malformation (0-1%)
    • Vessel-rich tumour (5-15%)
    • Capillary hyperemia (3-8%)
  • Venous
  • Other
    • Semicircular canal dehiscence (0-5%)
    • Other (4-8%)
  • Unknown (20-23%)

Clinical Manifestations

  • May be subjective (only heard by patient) or objective (also heard by physician)