Differential Diagnosis for Pulsating Tinnitus
- Single most likely diagnosis
- Benign intracranial hypertension (BIH) or idiopathic intracranial hypertension (IIH): This condition is characterized by increased intracranial pressure without a detectable cause, often presenting with pulsating tinnitus, headache, and visual disturbances.
- Other Likely diagnoses
- Middle ear problems (e.g., otosclerosis, middle ear effusion): Conditions affecting the middle ear can cause pulsating tinnitus due to abnormal sound conduction or middle ear pressure changes.
- Vascular anomalies (e.g., arteriovenous malformations, carotid artery stenosis): Abnormal blood flow or vascular structures near the ear can lead to pulsating tinnitus.
- Thyroid disorders (e.g., hyperthyroidism): Certain thyroid conditions can cause pulsating tinnitus, possibly due to increased blood flow or other metabolic changes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Glomus jugulare tumor: A rare, highly vascular tumor in the jugular foramen that can cause pulsating tinnitus and other neurological symptoms.
- Dural arteriovenous fistula: An abnormal connection between arteries and veins in the dura mater that can lead to pulsating tinnitus, among other symptoms.
- Giant cell arteritis: An inflammatory condition affecting the blood vessels, which can cause pulsating tinnitus, headache, and visual disturbances.
- Rare diagnoses
- Otospongiosis (otosclerosis): A rare condition characterized by abnormal bone growth in the middle ear, which can cause pulsating tinnitus.
- Superior semicircular canal dehiscence: A rare condition where the bone over the superior semicircular canal is missing or thin, leading to pulsating tinnitus and other vestibular symptoms.
- Pseudotumor cerebri syndrome due to other causes (e.g., vitamin deficiencies, medication side effects): Other underlying conditions can cause increased intracranial pressure, leading to pulsating tinnitus.