From the Guidelines
Pulsatile tinnitus, also known as red flag tinnitus, is often caused by underlying vascular anomalies or abnormalities, such as vascular masses, aberrant arterial or venous anatomy, vascular malformations, and intracranial hypertension, which require immediate medical attention to prevent serious complications 1. The causes of pulsatile tinnitus can be attributed to various factors, including:
- Vascular masses 7, 8, 9
- Aberrant arterial or venous anatomy 10, 11
- Vascular malformations 12, 13
- Intracranial hypertension 14, 15, 16
- Turbulent flow in the setting of atherosclerotic carotid artery disease
- Jugular bulb abnormalities
- Abnormal condylar and mastoid emissary veins It is essential to note that objective tinnitus is rare and may be attributed to muscle spasm or myoclonus, or Eustachian tube dysfunction, which can be distinguished from vascular causes through physical examination and correlation with imaging results 1. Imaging studies, such as temporal bone CT and CTA, are appropriate to evaluate for a middle ear mass or vascular etiology in patients with pulsatile tinnitus, while MRI may be considered as a non-invasive alternative to screen for suspected intracranial vascular malformations 1. In patients with pulsatile tinnitus, it is crucial to perform a thorough history and physical examination to determine the need for imaging and to guide further evaluation and management 1.
From the Research
Causes of Red Flag Tinnitus (Pulsatile Tinnitus)
There are no research papers provided that directly discuss the causes of red flag tinnitus (pulsatile tinnitus). However, some studies provide information on tinnitus in general:
- The provided studies focus on the assessment and management of tinnitus, sound therapy, and the use of anticonvulsants for tinnitus treatment 2, 3, 4.
- Some studies explore the relationship between high-frequency hearing loss and tinnitus, suggesting that high-frequency audiometry may be useful in the diagnosis of tinnitus 5, 6.
- These studies do not specifically address the causes of red flag tinnitus (pulsatile tinnitus), but rather discuss tinnitus as a broader condition.
- The causes of red flag tinnitus (pulsatile tinnitus) may be related to various factors, but the provided studies do not offer direct evidence or insights into this specific topic.