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[Jugular megabulb as a cause of pulsatile tinnitus]
S Abilleira1, F Romero-Vidal, J Alvarez-Sabín
1Servicio de Neurología, Hospital General Universitari de la Vall d'Hebron, Barcelona, España.
Introduction:
Pulsatile tinnitus (AP), possibly of vascular origin, may be a sign of various vascular and non-vascular pathological processes. Arteriovenous fistulas and malformations are, perhaps, the commonest cause of AP.
Clinical Case:
A 64 year-old woman presented with AP of the right ear for the past 14 years. It was continuous all day and could be observed externally by the examiner. The intensity of the tinnitus diminished on right later-cervical compression and on turning her head to the left. There was bilateral transmission deafness. Neurological examination was normal. Complementary explorations (MR, CT of the base of the skull and cerebral arteriography) showed the presence of a jugular megabulb of the right side.
Conclusions:
The presence of AP may be for many years the only sign of subjacent vascular pathology, such as a megabulb of the jugular vein.