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Pulsatile tinnitus

Srikanth Boddu, Marc Dinkin, Maria Suurna, Kelly Hannsgen, Xem Bui, Athos Patsalides
OBJECTIVE: Evaluate the role of venous sinus stenting in the treatment of pulsatile tinnitus among patients with Idiopathic Intracranial Hypertension (IIH) and significant venous sinus stenosis. SUBJECTS AND METHODS: A written informed consent approved by the Weill Cornell institutional review board was signed and obtained from the study participants. Thirty-seven consecutive patients with IIH and venous sinus stenosis who were treated with venous sinus stenting between Jan...
2016: PloS One
Rong Zeng, Guo-Peng Wang, Zhao-Hui Liu, Xi-Hong Liang, Peng-Fei Zhao, Zhen-Chang Wang, Shu-Sheng Gong
OBJECTIVE: To evaluate clinical characteristics and present surgical outcomes of PT caused by sigmoid sinus wall dehiscence (SSWD). METHODS: This study retrospectively reviewed 34 patients with PT who were diagnosed with SSWD in our institution between December 2008 and July 2013. Among them, 27 patients underwent sigmoid sinus wall reconstruction (surgery group) and 7 patients refused surgery (non-surgery group). Preoperative data were obtained from the patients' medical records...
2016: PloS One
Beau B Bruce, Kathleen B Digre, Michael P McDermott, Eleanor B Schron, Michael Wall
OBJECTIVE: To examine the changes in vision-specific and overall health-related quality of life (QOL) at 6 months in participants with idiopathic intracranial hypertension (IIH) and mild visual loss enrolled in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) and to determine the signs and symptoms of IIH that mediate the effect of acetazolamide on QOL. METHODS: We assessed QOL using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25), the 10-Item NEI-VFQ-25 Neuro-Ophthalmic Supplement, and the 36-Item Short Form Health Survey (SF-36)...
September 30, 2016: Neurology
Bradley A Gross, Karam Moon, Andrew F Ducruet, Felipe C Albuquerque
BACKGROUND/OBJECTIVE: The rarity of petrous internal carotid artery (ICA) aneurysms has largely precluded analyses of their presentation and management in case series format. METHODS: We performed a retrospective analysis of our endovascular database of patients treated from January 2001 to May 2016 to identify patients with petrous ICA aneurysms. We evaluated the treatment approach and results for patients managed in the era of dedicated intracranial stents and flow diverters, noting clinical and angiographic results...
September 26, 2016: Journal of Neurointerventional Surgery
Lien Devuyst, Luc Defreyne, Marleen Praet, Sven Geukens, Ingeborg Dhooge
PURPOSE: The purpose of this study was to evaluate the effectiveness on function preservation and tumor control of the treatment of glomus tympanicum tumors with pre-operative embolization followed by total surgical resection. MATERIAL AND METHODS: We describe a series of 6 patients with a glomus tympanicum tumor who were treated in our hospital using the same technique: the day before surgery selective tumor embolization due to denaturation with 96% ethanol. Following parameters were considered: tumor classification, tumor control, clinical and audiological outcome, effectiveness of embolization, percentage of tumor necrosis and treatment complications...
September 7, 2016: American Journal of Otolaryngology
Srinivasan Paramasivam, Sunil Furtado, Tomoyoshi Shigamatsu, Eric Smouha
Sigmoid sinus diverticulum (SSD) is a rare vascular disorder due to dehiscence of the sigmoid plate. It may be associated with prediverticular venous sinus stenosis (SS) and usually presents as pulsatile tinnitus. The mechanism of development of the SSD and tinnitus from a sinus diverticulum and associated SS is unclear. Previous case reports have suggested that remodeling of the venous system targeting the stenosis, elimination of the diverticulum, or both, have resulted in symptom relief. We present a case of SSD with SS, treated by stenting of the stenosis along with coil embolization of the diverticulum, resulting in complete relief of symptoms...
June 2016: Interventional Neurology
Jean-Philippe Van Damme, Géraldine Heylen, Chantal Gilain, Pierre Garin
Dehiscent internal carotid artery (ICA) in the middle ear is a rare condition, with conservative treatment primarily recommended. We report the case of a 63-year-old patient referred to the Ear, Nose, and Throat (ENT) ward for unbearable pulsatile tinnitus. Otoscopy revealed a normal right tympanic membrane, with pulsatile tinnitus but without hearing impairment. Based on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone, as well as Doppler ultrasound of the internal carotid artery and sigmoid sinus, the diagnosis of ICA canal dehiscence into the tympanic cavity was established, thus excluding the diagnosis of aberrant ICA...
September 1, 2016: Auris, Nasus, Larynx
Bradley A Gross, Felipe C Albuquerque, Karam Moon, Cameron G McDougall
OBJECTIVE Many small series and technical reports chronicle the evolution of endovascular techniques for cranial dural arteriovenous fistulas (dAVFs) over the past 3 decades, but reports of large patient series are lacking. The authors provide a thorough analysis of clinical and angiographic outcomes across a large patient cohort. METHODS The authors reviewed their endovascular database from January 1996 to September 2015 to identify patients harboring cranial dAVFs who were treated initially with endovascular approaches...
September 2, 2016: Journal of Neurosurgery
Hyoung Won Jeon, So Young Kim, Byung Se Choi, Yun Jung Bae, Ja-Won Koo, Jae-Jin Song
OBJECTIVE: In patients with pulsatile tinnitus (PT), physical examination such as auscultation with head position change or digital compression over the ipsilateral jugular vein provides physicians with important information. However, objective diagnosis of PT is sometimes limited because 1) audible bruit is absent on auscultation in some patients, 2) abnormal vascular structures found in radiologic evaluation is not always pathognomonic because they can be found in asymptomatic subjects as well, and 3) although an objective diagnostic tool using transcanal sound recording has recently been introduced, special equipment is needed...
October 2016: Otology & Neurotology
Mitchell R Dobberpuhl, Stevie Maxwell, Jonathan Feddock, William St Clair, Matthew L Bush
OBJECTIVES: The objectives were to evaluate the audiological outcomes, response of symptoms, and response of tumor volume in patients with glomus jugulare tumors treated solely with single fraction gamma knife radiosurgery. STUDY DESIGN: Single institution retrospective review. SETTING: Academic, tertiary referral center. PATIENTS: The diagnosis code for glomus jugulare was used to identify patients. Only those who underwent gamma knife radiosurgery were included...
October 2016: Otology & Neurotology
Han Lv, Pengfei Zhao, Zhaohui Liu, Guopeng Wang, Rong Zeng, Fei Yan, Cheng Dong, Ling Zhang, Rui Li, Peng Wang, Ting Li, Shusheng Gong, Zhenchang Wang
Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027-0.073 Hz, and slow-5, 0.010-0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp...
2016: Neural Plasticity
Sunil Manjila, Kunal Kumar, Ashish Kulhari, Gagandeep Singh, Richard S Jung, Robert W Tarr, Nicholas C Bambakidis
The external carotid artery's lingual branch to retromandibular venous fistula following a carotid endarterectomy has not been reported earlier in literature. We report a unique case of an 87-year-old man who had a right-sided carotid endarterectomy in 2009 and presented four years later with complaints of fullness and discomfort in the area of right parotid gland with associated pulsatile tinnitus. A computed tomography (CT) scan of the neck revealed a deep portion of the right parotid gland having abnormal aneurysmal dilatation of a vascular structure, which appeared to be an arteriovenous fistula between branches of right external carotid artery and the retromandibular vein...
June 2016: Journal of Vascular and Interventional Neurology
Baomin Li, Xianli Lv, Zhongxue Wu, Xiangyu Cao, Jun Wang, Aili Ge, Xinfeng Liu, Sheng Li
When tinnitus is pulse-synchronous, a vascular etiology is suggested. We present a case of persistent and troublesome pulsatile tinnitus caused by a transverse-sigmoid sinus diverticulum that was endovascularly treated with stent-assisted coiling. A 39-yearold woman presented with a 4-year history of progressive pulsatile tinnitus involving the right ear. Slight pulsatile bruit was heard on the right mastoid bone by auscultation. Cerebral angiography demonstrated a diverticulum of the transverse-sigmoid sinus...
2016: Turkish Neurosurgery
Paolo Cariati, Ana-Belen Marin-Fernandez, Fernando Monsalve-Iglesias, Maria Roman-Ramos, Blas Garcia-Medina
UNLABELLED: The ocurrence of a traumatic arteriovenous fistula after arthroscopic surgery of TMJ represents an extremely rare event. Specifically, this uncommon complication has been described only in a few case reports. In this light, the most frequent symptoms showed by this disease are thrills, bruits, pulsatile tinnitus, and an expansible vascular mass. Importantly, the severity of these symptoms is also dependent on the vessels involved. With regard to the management, is important to note that the vessel ligation with surgery as well as vessel emolization with endovascular procedures have been shown to be effective in the treatment of these cases...
July 2016: Journal of Clinical and Experimental Dentistry
Taija K Nicoli, Saku T Sinkkonen, Turkka Anttila, Antti Mäkitie, Jussi Jero
Treatment of jugulotympanic paragangliomas (JTPGLs) remains challenging with no clear guidelines for management or follow-up. The aim of this retrospective case-note study was to assess long-term results of operatively and conservatively managed JTPGLs between years 1974-2013. A total of 36 patients with JTPGLs were identified. Clinical characteristics and management outcomes of patients were reviewed. Data were extracted on demographics, symptoms, timing of diagnosis, tumor location and size, embolization, and management, including pre- and post-operative imaging, analysis of operative techniques, and follow-up...
July 5, 2016: European Archives of Oto-rhino-laryngology
C Dong, P Zhao, Z Liu, W Xu, H Lv, S Pang, Z Wang
AIM: To assess the extent of sigmoid sinus dehiscence (SSD) on high-resolution computed tomography venography (HRCTV) or high-resolution computed tomography (HRCT) images in pulsatile tinnitus (PT) and non-PT groups to determine whether there is an association between the extent of SSD and occurrence of PT. MATERIALS AND METHODS: Twenty-eight SSD patients with ipsilateral PT and 28 age- and gender-matched SSD patients without PT who underwent HRCTV or HRCT were enrolled in this study and categorised into two groups: "PT group" and "non-PT group"...
September 2016: Clinical Radiology
Shin Hye Kim, Gwang Seok An, Inyong Choi, Ja-Won Koo, Kyogu Lee, Jae-Jin Song
OBJECTIVE: Although vascular pulsatile tinnitus (VPT) has been classified as "objective", VPT is not easily recognizable or documentable in most cases. In response to this, we have developed transcanal sound recording (TSR) and spectro-temporal analysis (STA) for the objective diagnosis of VPT. By refining our initial method, we were able to apply TSR/STA to post-treatment outcome evaluation, as well as pre-treatment objective diagnosis. METHODS: TSR was performed on seven VPT patients and five normal controls before and after surgical or interventional treatment...
2016: PloS One
Yıldız Arslan, İlker Burak Arslan, Yeliz Pekçevik, Ufuk Şener, Şükran Köse, Yaşar Zorlu
BACKGROUND: Matrix metalloproteinases (MMPs) are enzymes suggested as a possible candidate for pathogenesis of arterial dolichoarteriopathy (DA). We aimed to investigate the relationship between MMP levels and DA of intra- and extracranial carotid arteries. METHODS: This study included 88 subjects admitted with headache, vertigo, or pulsatile tinnitus and those who underwent computed tomography angiography. The study group (n = 70) consisted of patients with kink-coiling (group I, n = 41) and patients with tortuosity (group II, n = 29)...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Radek Frič, Per Kristian Eide
OBJECTIVE Several lines of evidence suggest common pathophysiological mechanisms in Chiari malformation Type I (CMI) and idiopathic intracranial hypertension (IIH). It has been hypothesized that tonsillar ectopy, a typical finding in CMI, is the result of elevated intracranial pressure (ICP) combined with a developmentally small posterior cranial fossa (PCF). To explore this hypothesis, the authors specifically investigated whether ICP is comparable in CMI and IIH and whether intracranial volumes (ICVs) are different in patients with CMI and IIH, which could explain the tonsillar ectopy in CMI...
June 24, 2016: Journal of Neurosurgery
Glen Watson, Amanda McSorley, Vivek Kaushik
Vascular tumors arising in the temporal bone represent 0.7% of all lesions in this area. Hemangiomas confined to the tympanic membrane are exceptionally rare. We report a new case of tympanic membrane hemangioma that arose in 59-year-old man who presented with a 2-month history of constant right-sided pulsatile tinnitus and associated neck discomfort. The lesion and a cuff of healthy tympanic membrane were excised, and the resulting defect was repaired with a temporalis fascia graft. At 3 months, the neotympanum was well healed and the patient's symptoms had resolved...
June 2016: Ear, Nose, & Throat Journal
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