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Pulsatile tinnitus associated with a laterally placed sigmoid sinus

C J Mehall¹, H I Wilner, M J LaRouere

¹Department of Radiology, Wayne State University, Harper Hospital, Detroit, MI 48201, USA.

AJNR. American Journal of Neuroradiology

|April 1, 1995

Summary

A rare case of pulsatile tinnitus was linked to a sigmoid sinus positioned unusually laterally. Imaging confirmed the sinus eroded the mastoid bone, causing the subjective sound.

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Area of Science:

Neurology
Radiology
Otolaryngology

Background:

Pulsatile tinnitus can be caused by vascular abnormalities.
Sigmoid sinus abnormalities are uncommon causes of tinnitus.

Observation:

A patient presented with subjective pulsatile tinnitus.
Computed tomography (CT) revealed an enhancing lesion eroding the medial wall of the right mastoid.

Findings:

Two-dimensional time-of-flight MR angiography and conventional cerebral angiography demonstrated a tortuous and laterally deviated sigmoid sinus.
The lateral sinus position and erosion likely contributed to the pulsatile tinnitus.

Implications:

This case highlights the importance of considering sigmoid sinus anomalies in the differential diagnosis of pulsatile tinnitus.

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Advanced imaging techniques are crucial for accurate diagnosis and management of such conditions.