Pulsatile tinnitus associated with internal carotid artery morphologic abnormalities.
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.
Sismanis
Aristides
A
Department of Otolaryngology-Head, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. asismanis@aol.com
Girevendoulis
Alexander
A
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