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Vascular loop in the cerebellopontine angle causing pulsatile tinnitus and headache: a case report
N A Ramly1, A R Roslenda1, A Suraya1
1Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Jalan Yaacob Latif, 56000 Kuala Lumpur, Malaysia.
EXCLI Journal
|September 30, 2015
Summary
Pulsatile tinnitus in a young woman was linked to a looping artery near cranial nerves. This case highlights vascular abnormalities as a cause of tinnitus, even without typical risk factors.
Area of Science:
- Neurology
- Otolaryngology
- Radiology
Background:
- Tinnitus is a common auditory disorder, categorized as pulsatile/non-pulsatile or objective/subjective.
- Pulsatile tinnitus, though less common, often stems from vascular abnormalities or tumors.
Observation:
- A 30-year-old Malay woman presented with a two-year history of worsening pulsatile tinnitus and intermittent headaches.
- Clinical and audiological evaluations revealed mild high-frequency hearing loss in the left ear; pure tone audiogram was otherwise normal.
- Magnetic resonance imaging (MRI) was performed due to the patient's young age and lack of typical risk factors for hearing loss.
Findings:
- MRI revealed a single anomalous blood vessel looping around the left vestibulocochlear and facial nerves in the cerebellopontine angle.
- The vessel was identified as a likely branch of the anteroinferior cerebellar artery (AICA).
Implications:
- This case underscores the importance of considering vascular anomalies, such as aberrant arteries, in the differential diagnosis of pulsatile tinnitus, particularly in young individuals.
- Further investigation into the pathophysiology and management of tinnitus caused by neurovascular compression is warranted.
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