title: Pulsatile tinnitus associated with internal carotid artery morphologic abnormalities.
abstract: OBJECTIVE
  Internal carotid artery morphologic abnormalities mainly consist of tortuosities and coilings and can present with pulsatile tinnitus (PT). The purpose of this presentation is to report 3 representative cases and propose clinical and radiologic diagnostic criteria.
  
  
  METHODS
  Three patients presenting with PT.
  
  
  METHODS
  Clinical evaluation including auscultation of the ear canal and head and neck. All patients underwent computed tomography angiography of the head and neck.
  
  
  METHODS
  Clinical evaluation, computed tomography angiography of the head and neck.
  
  
  RESULTS
  Head bruit or objective tinnitus were detected in 2 patients. Symptoms of cerebral ischemia were absent. All patients were found to have tortuosities of the internal carotid arteries below the cranium base. One patient, in addition to tortuosity, had coiling as well.
  
  
  CONCLUSIONS
  Morphologic abnormalities of the internal carotid artery may be associated with PT. Proper clinical evaluation coupled with computed tomography angiography of the head and neck can differentiate these abnormalities from other more serious vascular etiologies. Symptoms of cerebral ischemia warrant consultation with a vascular surgeon.
authors.affiliation: Department of Otolaryngology-Head, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. asismanis@aol.com
authors.forename: Aristides
authors.initials: A
authors.lastname: Sismanis
authors.forename: Alexander
authors.initials: A
authors.lastname: Girevendoulis
mesh_terms: D001314:Auscultation; D002545:Brain Ischemia / Q000150:complications; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000150:complications; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D014012:Tinnitus / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed