Tinnitus is a common symptom encountered by otolaryngologists. Pulsatile tinnitus is rare and can present a diagnostic challenge. Establishing a diagnosis is important, because pulsatile tinnitus may indicate serious intracranial or extracranial disease. A unique case of pulsatile tinnitus caused by cervical artery dissection is presented, along with the differential diagnosis and treatment.
GlasscockMEDickinsJREJacksonCGWietRJ. Vascular anomalies of the middle ear. Laryngoscope1980: 90: 77–88.
2.
LevequeHBialostozkyFBlanchardCLSuterCM. Tympanometry in the evaluation of vascular lesions of the middle ear and tinnitus of vascular origin. Laryngoscope1979: 89: 1197–218.
3.
GulyaAJSchuknechtHF. A large artery in the apical region of the cochlea of a man with pulsatile tinnitus [Letter]. Am J Otol1984; 5: 262.
4.
WardPHBabinRCalcaterraTCKonradHR. Operative treatment of surgical lesions with objective tinnitus. Ann Otol Rhinol Laryngol1975; 84: 473–82.
5.
DaviesDG. Paget's disease of the temporal bone. Acta Otolaryngol Suppl (Stockh)1968(suppl 242).
6.
SismanisAStammMASobelM. Objective tinnitus in patients with atherosclerotic carotid artery disease. Am J Otol1994; 15: 404–7.
7.
HartRGEastonDJ. Dissection of cervical and cerebral arteries. Neurol Clin1983; 1: 155–82.
LiMSSmithBMEspinosaJBrownRARichardsonPFordR. Nonpenetrating trauma to the carotid artery: Seven cases and a literature review. J Trauma1994; 36: 265–72.
12.
FisherCMOjemannRGRobersonGH. Spontaneous dissection of cervicocerebral arteries. Can JNeurol Sci1978; 5: 9–19.
13.
RoomeNSAberfeldDC. Spontaneous dissecting aneurysms of the internal carotid artery. Arch Neurol1977; 34: 251–2.
14.
PitnerSE. Carotid thrombosis due to intraoral trauma: An unusual complication of a common childhood accident. N Engl J Med1966; 56: 857–60.
HinsePTheiALachenmayerL. Dissection of the extracranial vertebral artery: Report of four cases and review of the literature. J Neurol Neurosurg Psychiatry1991; 54: 863–9.
30.
ShermanDGHartRGEastonJD. Abrupt change in head position and cerebral infarction. Stroke1981; 12: 2–6.
31.
PretreRRevererdinAKalonjiTFaiduttiB. Blunt carotid artery injury: Difficult therapeutic approaches for an unrecognized entity. Surgery1994; 115: 375–81.
32.
LevyCPierre LaisseyPRaveauV. Carotid and vertebral artery dissections: Three dimensional time of flight MR angiography and MR imaging versus conventional angiography. Radiology1994; 190: 97–103.
33.
ZuberMMearyEMederJFMasJL. Magnetic resonance imaging and dynamic CT scan in cervical artery dissections. Stroke1994; 25: 576–81.
34.
RotherJWentzKURautenbergWSchwartzAHennericiM. Magnetic resonance angiography in vertebrobasilar ischemia. Stroke1993; 24: 1310–5.
35.
BiousseVD'Anglejan-ChatillionJTouboulPJ. Time course of symptoms in extracranial carotid artery dissections: A series of 80 patients. Stroke1995; 26: 235–9.
36.
SturzeneggerM. Spontaneous internal carotid artery dissection; early diagnosis and management in 44 patients. J Neurol1995; 242: 231–8.
