Number of Radiologic Abnormalities Associated with Idiopathic Intracranial Hypertension as a Predictor of the Presence of Pulsatile Tinnitus

Pulsatile tinnitus (PT) is a common symptom in idiopathic intracranial hypertension (IIH). Previously published work suggests that the severity of individual MRI findings associated with IIH does not correlate with the presence of PT. However, recent studies suggest that other symptoms of IIH may be related to the number (rather than severity) of abnormal MRI findings. The purpose of this study is to determine if there is a difference in the number of abnormal MRI findings in those with and without PT.

We performed a retrospective, age-matched cohort study of patients with documented IIH and MRI head, assessing for the total number of abnormal MRI findings out of 16 variables associated with IIH. The groups were then stratified in numerous ways. Analysis was performed on each of these grouping strategies to assess the difference between PT+ and PT- cohorts and between low-, medium-, and high-number abnormal findings groups.

A total of 80 age-matched patients met the inclusion criteria (40 PT+, 40 PT-). There was no statistically significant difference in the number of positive MRI findings between PT+ and PT- cohorts, 6.13 ± 2.77 and 6.68 ± 3.47, respectively (P = 0.572). Grouping patients into cohorts based on the number of findings revealed no significant differences. Furthermore, separating patients into groups above (P = 0.309) and below (P = 0.471), 7 total MRI findings did not demonstrate significant differences between PT+ and PT- cohorts.

The presence of PT does not correlate with the total number of MRI abnormalities. This reinforced current evidence that PT in patients with IIH is likely not related to the severity or chronicity of IIH.