Self-audible venous bruits and high jugular bulb

Area of Science:

• Otolaryngology
• Neurology
• Vascular Medicine

Background:

• Self-audible venous bruits are uncommon and their etiology is often unclear.
• Previous hypotheses suggested increased intracranial pressure as a cause.

Observation:

• Five patients presented with unilateral, pulsatile
• whooshing
• sounds audible only to themselves.
• These sounds were transient, alleviated by neck pressure or specific head movements, and exacerbated by increased cardiac output.
• Examiners could not detect the bruits.

Findings:

• A strong association was found between self-audible venous bruits and ipsilateral high jugular bulbs.
• This suggests a mechanical origin related to vascular anatomy.
• Intracranial pressure alone, without jugular bulb abnormality, appears insufficient to cause these self-audible bruits.

Implications:

• Highlights a benign cause for patient-reported pulsatile tinnitus or head noises.
• Suggests focusing on jugular bulb anatomy in diagnosing such symptoms.
• Differentiates these bruits from those potentially related to serious intracranial pathology.