title: Treatment of dural arteriovenous fistulas presenting as pulsatile tinnitus.
abstract: OBJECTIVE
  To describe the clinical picture and treatment of dural arteriovenous fistulas (DAVFs) presenting as pulsatile subjective tinnitus.
  
  
  METHODS
  Review of prospectively collected data.
  
  
  METHODS
  Academic referral center.
  
  
  METHODS
  Fourteen patients with clinically and radiographically diagnosed DAVFs.
  
  
  METHODS
  Treated by endovascular route.
  
  
  METHODS
  Treatments, clinical course, complications, and evolution were evaluated.
  
  
  RESULTS
  All patients presented with sleep-disruptive pulsatile tinnitus. Other symptoms included severe headaches, papilledema, proptosis, blepharoptosis, visual disturbances, and hemiparesis. Cortical venous drainage was present in 4 cases. Endovascular treatment was performed at least once by the arterial route in 14 patients and the venous route in 4 patients. The origin of tinnitus was always a vessel in or above the petrous bone. When these arteries or veins could not be visualized in the final control, the tinnitus disappeared. In the patients whose tinnitus returned, a vessel in the petrous bone could always be seen. There was no mortality.
  
  
  CONCLUSIONS
  Endovascular treatment is an effective and safe treatment of DAVFs presenting as tinnitus.
authors.affiliation: Department of Neuroradiology, Reina Sofía University Hospital, Department of Medicine (Dermatology, Medicine, and Otolaryngology), School of Medicine, University of Cordova, Cordova, Spain. fernando.delgado.sspa@juntadeandalucia.es
authors.forename: Fernando
authors.initials: F
authors.lastname: Delgado
authors.forename: Francisco
authors.initials: F
authors.lastname: Muñoz
authors.forename: Francisco
authors.initials: F
authors.lastname: Bravo-Rodríguez
authors.forename: Alfredo
authors.initials: A
authors.lastname: Jurado-Ramos
authors.forename: Rafael
authors.initials: R
authors.lastname: Oteros
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000209:etiology / Q000503:physiopathology; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D004621:Embolization, Therapeutic; D005094:Exophthalmos / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000209:etiology / Q000503:physiopathology; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D010579:Petrous Bone / Q000098:blood supply; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology; D014012:Tinnitus / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome