Cerebral dural arteriovenous fistulas presenting as pulsatile tinnitus

Chen, Y.‐J.; How, Chorng–Kuang; Chern, Chorng–Shyan

doi:10.1111/j.1445-5994.2007.01375.x

Cited by 9 publications

(10 citation statements)

References 4 publications

(14 reference statements)

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“…Turbulence due to increased flow or stenosis in vascular lesions transmits pulses to the inner ear 1 11. Such turbulence increases or decreases with corresponding alterations in flow, causing changes in symptom intensity with maneuvers such as carotid compression or Valsalva, as seen in the patient presented here.…”

Section: Discussionmentioning

confidence: 63%

“…Auditory sensation without external stimuli is known as tinnitus, and this sensation can coincide with one's heartbeat, an entity known as pulsatile tinnitus 1 4. Vascular etiologies typically cause the sensations, and history and physical examination play useful roles in localizing the source.…”

Section: Discussionmentioning

confidence: 99%

“…Most commonly, DAVF causes pulsatile tinnitus but other arterial pathologies include intracranial arterial aberrancy or redundancy, carotid cavernous fistula, atherosclerosis, vascular stenosis, arteriovenous malformation, aneurysm, dissection, and fibromuscular dysplasia 1 8 9. Venous etiologies include jugular bulb abnormalities, dural sinus stenosis, and sinus aberrancy 1 2 4 10. Such vascular etiologies tend to correlate with intracranial location, although thoracic or neck sources can occur 1.…”

Section: Discussionmentioning

confidence: 99%

“…Venous etiologies include jugular bulb abnormalities, dural sinus stenosis, and sinus aberrancy 1 2 4 10. Such vascular etiologies tend to correlate with intracranial location, although thoracic or neck sources can occur 1. Non-vascular causes include histiocytosis X, glomus tumor, high cardiac output, hydrocephalus, intracranial hypertension, tumor, myoclonus, and valvular heart disease 1 3 4 7…”

Section: Discussionmentioning

confidence: 99%

“…History and physical guide the imaging approach. Although catheter angiography remains the gold standard, MR angiography or CT angiography have largely replaced catheter angiography in the early evaluation 1. Other modalities, including general CT, MRI, or ultrasound, may play a diagnostic role depending on the lesions suspected 3 4 7…”

Section: Discussionmentioning

confidence: 99%

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Occipital artery anastomosis to vertebral artery causing pulsatile tinnitus

Alexander¹,

English²,

Hetts³

2013

BMJ Case Reports

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Pulsatile tinnitus can result from various vascular etiologies that cause transmission of pulsatile turbulent flow into the inner ear. Less commonly, non-vascular sources cause increased blood flow and transmission of sound perceived as tinnitus. Thorough clinical examination leads to appropriate imaging evaluation and therapeutic planning. Most pulsatile tinnitus results from expected mechanisms, such as dural arteriovenous fistula, jugular bulb dehiscence, or paraganglioma; however, the literature contains reports of numerous rare causes, particularly variant anatomic morphologies. We present the case of a novel cause of pulsatile tinnitus in which collateral vascular flow compensated for decreased normal intracranial cerebral arterial supply and might have caused catastrophic consequences if intervened upon after assumptions based on an incomplete evaluation.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Occipital artery anastomosis to vertebral artery causing pulsatile tinnitus

Alexander¹,

English²,

Hetts³

2013

BMJ Case Reports

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Increasing awareness with recognition of pulsatile tinnitus for nurse practitioners in the primary care setting

Vecchiarelli

Amar

Emanuele

2017

Journal of the American Association of Nurse Practitioners

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Background and purpose Pulsatile tinnitus is a whooshing sound heard synchronous with the heartbeat. It is an uncommon symptom affecting fewer than 10% of patients with tinnitus. It often goes unrecognized in the primary care setting. Failure to recognize this symptom can result in a missed or delayed diagnosis of a potentially life‐threatening condition known as a dural arteriovenous fistula. The purpose of this case study is to provide a structured approach to the identification of pulsatile tinnitus and provide management recommendations. Method A case study and review of pertinent literature. Conclusions Pulsatile tinnitus usually has a vascular treatable cause. A comprehensive history and physical examination will alert the nurse practitioner (NP) when pulsatile tinnitus is present. Auscultation in specific areas of the head can detect audible or objective pulsatile tinnitus. Pulsatile tinnitus that is audible to the examiner is an urgent medical condition requiring immediate consultation and referral. Implications for practice Knowledge of pulsatile tinnitus and awareness of this often treatable condition directs the NP to perform a detailed assessment when patients present with tinnitus, directs appropriate referral for care and treatment, and can reduce the risk of delayed or missed diagnosis.

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Diagnostik und Therapie duraler arteriovenöser Fisteln

et al. 2007

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Intradural arteriovenous fistulas can occur at any location within the dura mater. Patients can be clinically asymptomatic or show symptoms ranging from mild up to fatal hemorrhaging. Previously dural arteriovenous fistulas were often dealt with surgically via a variety of access routes. Since recent years there is now the possibility to close most dural arteriovenous fistulas by endovascular embolisation. In addition, stereotactic radiation therapy is available, which can also achieve good results especially in combination with surgery.

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Cerebral dural arteriovenous fistulas presenting as pulsatile tinnitus

Cited by 9 publications

References 4 publications

Occipital artery anastomosis to vertebral artery causing pulsatile tinnitus

Occipital artery anastomosis to vertebral artery causing pulsatile tinnitus

Increasing awareness with recognition of pulsatile tinnitus for nurse practitioners in the primary care setting

Diagnostik und Therapie duraler arteriovenöser Fisteln

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