Cerebral Venous Thrombosis and Persistent Pulsatile Tinnitus After Sigmoid Sinus Resurfacing Surgery

We report a case with rare complication of cerebral venous thrombosis, as well as an incomplete response, after sigmoid sinus resurfacing surgery for pulsatile tinnitus (PT). A 24-year-old female patient with PT originating from the sigmoid sinus underwent sigmoid sinus resurfacing surgery. The tinnitus was immediately resolved, but it recurred with headache 5 days after surgery. A cerebral venous thrombosis was identified and treated, but PT persisted, although its frequency and loudness decreased. Sigmoid sinus resurfacing surgery is a safe and effective method to treat PT, but in some patients, it can cause serious complications and/or persistent tinnitus. In our patient, factors such as changes in blood viscosity due to warfarin intake or increased blood flow due to weight loss may have influenced the persistence of the tinnitus. It is important to identify the various associated factors and the weight of each of these factors to provide more tailored treatment of PT for individual patients in the future and to reduce complications and increase the effectiveness of sigmoid sinus resurfacing surgery.