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If It's September, It's Intracranial Hypertension (IH) Awareness Month!

Whooshers.com is a big supporter of all who raise awareness for intracranial hypertension (IH), a condition that impacts many, many whooshers and doesn't get enough attention. Since September is IH Awareness Month, let's chat a minute about IH, shall we?

According to the Intracranial Hypertension Research Foundation (IHRF), IH is the term for neurological disorders that result when cerebrospinal fluid (CSF) in the skull is too high.  Whooshing is sometimes the first and sole symptom of IH. There are different types of IH: Acute/Chronic; Idiopathic/Secondary - and different people with even the very same diagnosis may experience IH very differently.

Like a lot of causes of pulsatile tinnitus (and not unlike the symptom itself), IH has a bit of a PR problem. Not enough people know much about it, and medical professionals aren't necessarily trained to detect its symptoms.  It's one of those conditions that everyone has said for years is "rare," but really, it may just be "rarely diagnosed."  To make it more confusing, IH has had a number of different names, including pseudotumor cerebri and benign intracranial hypertension. 

PTCPhoto.JPG

This book was purchased in 2003 - even its title is outdated now! More organizations and support groups have since been born and there are a lot of wonderful people raising awareness and support, for the condition and for the people enduring the symptoms and finding their way to and through treatment.

But there's a lot left to be learned and shared. We've heard from a number of whooshers who were diagnosed with IH, and while the term "cure" is unfortunately not a common one associated with IH - not yet - the good news is once identified it is possible to find support and treatment. We've posted quite a few Whoosher-IH stories, including this one. I encourage more IHers to share their stories with us. 

If you don't know a lot about IH, one of the best things you can do is read about IH Myths.  For example, did you know that IH impacts MEN as well as women? It's true.  Did you know that you don't need to experience headaches or have vision problems to have IH? That's true, too.  Very often, even if doctors are familiar with IH, a patient will fall between the cracks because the myths - oh, the myths - keep many patients from receiving a proper evaluation. 

In its "Introduction," the (albeit outdated) book quotes Dr. C. Everett Koop, the former U.S. Surgeon General.  He said, "The best prescription is knowledge." I couldn't agree more. 

Learn more about IH! You'll be glad you did!

Mon, September 1, 2014 | link          Comments

Have Pulsatile Tinnitus? How To Get Your Doctor's Attention and Getting Beyond "Live With It"

Due to the fact that pulsatile tinnitus is a rare symptom, many of the emails I receive from patients go something like this:

"I have pulsatile tinnitus. My ENT thinks it's tinnitus. How do I convince him/her that pulsatile tinnitus is different, that it warrants medical testing, and that a cause may be identified?"

The key, I think, is to refer them to medical reports.  If your medical professionals give you a hard time about relying on "Dr Google," remind them that the reports/abstracts listed on Whooshers.com are from medical journals, which include pieces written by their colleagues: medical professionals who are familiar with our cases. If a doctor won't take time to read a medical report to learn more about an area s/he may not be so familiar with, well, I'd want to find another doctor. 

We here at Whooshers.com agree 100% that self-diagnosis is not in anyone's best interest and we recommend against it. But just because a medical report is online does not mean it's bogus. In fact, most medical journals now post articles and abstracts electronically, which has been a very positive factor in the recognition of and treatment for rare symptoms, including pulsatile tinnitus.  

Whooshers.com has scores of links to medical reports written by doctors, for doctors that explain the difference between tinnitus and pulsatile tinnitus and, more specifically, the medical workup warranted when a pulsatile tinnitus patient walks into a doctor's office.  You can find them under "Resources" on the home page and many, many more specific reports about specific causes and treatments on our Cured Whooshers page. The Cured Whooshers page also includes personal stories written by patients, many of whom articulate quite well the impact of the symptom during their journey toward a diagnosis and treatment.

Here is a list of a few resources to get you started, to put in your back pocket before heading to your next doctor's appointment:

1. Click Here to Download the PDF, "Top Ten Pulsatile Tinnitus Tips for Doctors." Review it with your GPs and ENTs!

(An easily printable, two page file of need-to-know information!)

2. Article: "Imaging in Pulsatile Tinnitus: Diagnostic Pearls and Potential Pitfalls," B. S. Purohit, R. Hermans, K. Op de beeck; 1SINGAPORE/SG, 2Leuven/BE, European Society of Radiology, 2014.

(The biggest pitfall of course being that pulsatile tinnitus is often regarded as tinnitus, when it's another kind of symptom, entirely.)

3. Report: "Pulsatile Tinnitus, Imaging and Differential Diagnosis." Erich Hofmann, Prof. Dr. med. Robert Behr, Prof. Dr. med., Tobias Neumann-Haefelin, Prof. Dr. med., and Konrad Schwager, Prof. Dr. med., Dtsch Arztebl Int. Jun 2013; 110(26): 451–458.

(Excellent, to-the-point report. The first sentence: "Pulsatile tinnitus, unlike idiopathic tinnitus, usually has a specific, identifiable cause.")

4. Show doctors the Whooshers.com petition for a pulsatile tinnitus diagnosis code. A number of doctors have signed it!

(That's right. There's no code yet. We need one, and so do the doctors who treat us. Not to mention that, if we had a code, health insurance companies would have less reason to fight our doctors when they order a diagnostic test.)

5. The Whooshers.com Cured Whooshers page.

(Many pulsatile tinnitus stories written by real patients who found answers and treatment. Many medical reports re the same. NO stories on tinnitus.)

PULSATILE TINNITUS IS NOT TINNITUS!

Sun, August 3, 2014 | link          Comments

Another Cured Whoosher: Brain Dural Arteriovenous Fistula (BDAVF)

The latest Cured Whoosher story from "Liz" is another inspiring (albeit frustrating!) tale of a patient who was told to "live with it," all while the evasive cause of her pulsatile tinnitus, brain dural arteriovenous fistula (BDAVF), could have caused a stroke, or worse. Her persistence was rewarded by answers and a procedure that cured her of the whoosh.  Reading other whoosher stories helped her throughout the process, so she wanted to give back and tell her story so it, too, may help other whooshers.

This will be added to our Cured Whooshers page, where we keep links to similar stories of persistence and varying underlying causes. We actually have several other stories from whooshers diagnosed with BDAVF.  Links to medical reports may be found there, too.  So, doctors: read up!

Liz, good for you for being your best advocate! Enjoy the silence.

In January 2013, a couple days after a dental cleaning appointment, I started having a severe headache, jaw ache and whooshing in my left ear.  It literally sounded like a 'whoosh, whoosh, whoosh' noise which was in time to my heartbeat.  It continued 24/7 and kept getting worse.  I had been suffering with cold and sinus issues for a couple of weeks, saw my primary physician and got antibiotics. Didn't get better. In February 2013, researching on the Internet brought me to Whooshers.com and that page (and the links) got me started thinking that with my symptoms that it might be pulsatile tinnitus. I read it might be related to high blood pressure, neck pain, Temporomandibular Joint Disorder (TMJ), all kinds of things.  I had high blood pressure so I checked it but could find no correlation to the whooshing.  My sleep was big time disrupted.  Saw my dentist re TMJ. Saw an ENT specialist who said ears were clear but could be TMJ.

From the beginning, I was able to shut the whoosh off by pressing on the back of my head behind my left ear, but then my head would hurt.  I had a physical and nothing showed up.  I gave up Aleve. I tried heat, ice, neck exercises, relaxation imagery for TMJ, watched my posture, tried white noise to sleep, tried a cotton ball in my ear, limited my chewing of hard stuff, essential oils and tried massage... nothing worked or really helped for long.

In April of 2013, I met with a second ENT specialist who ordered a hearing test which showed no problems with hearing - a good thing but no answer for whooshing.  He ordered an MRI to rule out a blood vessel tumor. This ENT had actually heard of pulsatile tinnitus (but not my primary or the first ENT).  My MRI showed blood vessels all good but I was sent me to physical therapy for my TMJ which did help a bit in at least managing the neck and jaw pain.  Apparently I carry a lot of tension in my neck and jaws.

The more I read on Whooshers.com the more nervous I became. I was then scheduled (per my ENT) for an ultrasound Doppler which also returned clear but found a thyroid nodule.  Next up was a MRI/MRA/MRV, and I was hopeful because these were all terms I had read about. Meanwhile the whoosh continued 24/7 and drove me completely bonkers!

During one of my sleepless nights I had read it was possible to record my whoosh and I was able to do that (can't remember how but finally friends and family could hear what I had been hearing). I played the whoosh for the second ENT referral and he said could hear it a little on my recording.

[Listen to Liz's Whoosh on the Whooshers Sounds page]

I kept pushing my primary about further testing of my thyroid nodule because I read that too can cause pulsatile tinnitus... this whole thing was quite a frustrating process to this point. Through this whooshing noise, I kept getting sick with infections, low temperatures, extreme debilitating fatigue, just general feeling like crap all the time.

In January of this year (2014), The ENT found a neurosurgeon for me to talk to about my symptoms. I met him in February. 

The neurosurgeon heard my whoosh (bruit) (woohoo), had heard of Whooshers.com, had heard of pulsatile tinnitus and he could actually feel it (trill).  He had reviewed all my scans and said he was fairly sure it was a dural arteriovenous fistula but didn't think I needed to repeat all the scans, just do the gold standard test of angiogram.  Did I mention when I finally saw the neurosurgeon's card it said "neurointerventionalist!!!! I knew from Whooshers.com that was the doctor that might be able to figure this out and he did!!!!!!! And he had heard the whoosh too...what a relief that was!!!

Backtracking a little, a few weeks prior to my procedure my head had begun to hurt a lot and every little tiny touch made my head hurt worse and worse. I was getting more worried and not sure what the heck was going on but was glad I already had an appointment scheduled.

On April 22, I had my diagnostic angiogram and after 4 plus hours, they were able to find and fix my fistula with an onyx embolization - YAHOO!!!! The neurosurgeons (
I had two neurosurgeons work on me) said my situation was a textbook case for BDAVF.  I spent the night in the hospital and woke up with NO whoosh!!!!  From what I understood they had found a big mess of criss-crossed arteries and veins and blood flow starting to go backwards which was probably why I was feeling worse.  If it hadn't been found and fixed it could have possibly led to a brain bleed or stroke.

I am soooo grateful to them and thankful and blessed to have no more whoosh.  The relentless24/7 whoosh was rough and  'peace' can not be underestimated.  I don't know how everyone can continue longer than I had but it was so helpful to read everyone's stories on here....a little scary to read sometimes but helpful overall :-))) and it was hard for me to do but you just have to keep pushing for answers. I wish nothing but cured whooshers for everyone on here.

Note: It's now almost 3 months after my procedure and I am still whoosh free.  I was told I would lose my hair in that left back quadrant of my head and I did.  Still waiting for it to grow back lol but that's a minor issue compared to what could have happened.  I will have a follow-up angiogram in another 3 months just to make sure everything still okay. 
 

For more information about brain dural arteriovenous fistula, see this link at neuroangio.org.

Sat, July 19, 2014 | link          Comments

Reports on Imaging and Diagnostic Evaluation: Possible Diagnosis in 57% of Pulsatile Tinnitus Cases

A recently published study that evaluated pulsatile tinnitus cases from 2002-2013, reports a comprehensive presentation of the complex nature of our cases and the tests that doctors should consider to investigate the underlying cause of pulsatile tinnitus.

Have you seen a doctor who has told you that you have to "live with" pulsatile tinnitus before ordering a series of diagnostic tests? Maybe it's time to show them these reports, written by their colleagues: doctors familiar with pulsatile tinnitus.

In pulsatile tinnitus cases, there are usually no easy answers, no specific "go-to" test that will rule everything out, no direct checklist of tests for "proper' evaluation. 

Is it easy to determine the cause? Usually not. Should each PT patient learn to "live with it," as we're often told, before a single diagnostic test? Absolutely not.

As the report indicates, "The role of the radiologist is to identify all treatable causes of PT. It is
necessary to be aware of the pertinent imaging findings and potential
imaging pitfalls of the common etiologies of PT."

Another report, written a couple of years ago but similar in its recommendations for thorough evaluation and testing, states, "In patients with PT however, imaging may be positive in up to
57- 100 % of patients though about 20-30% of these patients have 'normal variants' of
controversial significance..."

The more medical professionals appreciate the complexities of our cases, the closer we all get to proper evaluation of the symptom. And in more and more cases, the closer we get to a diagnosis, treatment -- and silence!  

Special thanks to the reader who gave me the heads up about these reports!

"Imaging in Pulsatile Tinnitus: Diagnostic Pearls and Potential
Pitfalls," B. S. Purohit, R. Hermans, K. Op de beeck; 1SINGAPORE/SG,
2Leuven/BE, European Society of Radiology, 2014.

"Imaging In Pulsatile Tinnitus : When Should It Ring A Bell?" G. Bathla1, V. Chong; 1singapore/SG, 2Singapore/SG, European Society of Radiology, 2012.

Sat, June 28, 2014 | link          Comments

Pulsatile Tinnitus and Fibromuscular Dysplasia (FMD): A Study

I was contacted by the FMDSA and doctors involved in a recent study that examined the relationship between Fibromuscular Dysplasia (FMD) and pulsatile tinnitus.

Below is an image capture of the chart that they've provided permission for me to reprint. For a link to the file in printable, .PDF form, look under "Resources" on the right-hand side of this page for the file, "Article: Unraveling Pulsatile Tinnitus in FMD; A Report of the United States Registry for Fibromuscular Dysplasia." 

Full Source:

"Unraveling Pulsatile Tinnitus in FMD; A Report of the United States Registry for Fibromuscular Dysplasia," Redah Zainub Mahmood; Jeffrey Olin; Xiaokui Gu; Eva Kline-Rogers; James Froehlich; J. Michael Bacharach; Yung-Wei Chi; Bruce Gray; Michael Jaff; Barry Katzen; Soo Hyun Kim; Pamela Mace; Robert McBane; Aditya Sharma; Christopher White; Heather Gornik, J Am Coll Cardiol. 2014;63(12_S).
 
For more information on FMD, be sure to visit FMDSA.org. Information about the annual FMDSA conference, this year held on May 17, 2014, may be found here.

ACC.14FMDPTposter5.jpg

UPDATE: The Cleveland Clinic links to Whooshers.com as a resource for FMD patients and the medical professionals who treat them. 

Sun, April 13, 2014 | link          Comments

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RESOURCES

NEW: Click Here to Download the PDF, "Top Ten Pulsatile Tinnitus Tips for Doctors." Review it with your GPs and ENTs!

Radiation Dose Chart - American Nuclear Society (ANS) Public Information Resources Page: Click here for an interactive dose chart for various medical diagnostic tests. A downloadable and printable version is also available on this page. Discuss with your doctors.

Find a Neurotologist: American Neurotological Society (ANS) Membership Roster 2013-2014, by state. NEW! (This PDF file will download when you click here)

Find a Neurointervention Specialist: Society of Neurointerventional Surgery (SNIS)- Click on "Physician Locator"

Find a Neuro-Ophthalmologist: The North American Neuro-Ophthalmology Society (NANOS)

Site: Neuroangio.org - Your neurovascular education and information resource. Patient Information.

Blog: Tales From Clark Street

Presentation: "Algorithm for Evaluation of Rhythmic Tinnitus," Douglas E Mattox, MD, Patricia Hudgins, MD, Jahrsdoerfer Lecture, University of Virginia, March 25, 2010. (This link is to the abstract/summary)

Presentation: "Imaging of the Patient with Tinnitus," Mary Beth Cunnane MD, Massachusetts Eye and Ear Infirmary, Dec 2013. (NEW! Mentions Pulsatile Tinnitus and Whooshers.com. Republished with Permission.)

Article: "Imaging in Pulsatile Tinnitus: Diagnostic Pearls and Potential Pitfalls," B. S. Purohit, R. Hermans, K. Op de beeck; 1SINGAPORE/SG, 2Leuven/BE, European Society of Radiology, 2014.

Article: "Imaging In Pulsatile Tinnitus : When Should It Ring A Bell?" G. Bathla1, V. Chong; 1singapore/SG, 2Singapore/SG, European Society of Radiology, 2012."

Article: "Emma's Story," A Personal Account of Pulsatile Tinnitus, The British Tinnitus Association (BTA).

Article: "Pulsatile Tinnitus: Contemporary Assessment and Management," Aristides Sismanis, Current Opinion in Otolaryngology & Head & Neck Surgery: October 2011 - Volume 19 - Issue 5 - p 348357 doi: 10.1097/MOO.0b013e3283493fd8, Otology and neuro-otology: Edited by Myles L. Pensak.

Article: "Temporal Bone: Vascular Tinnitus," William W.M. Lo and M. Marcel Maya, Vascular, pp.1361-1374, 2003.

Article: "Diagnostic Clues in Pulsatile Tinnitus (Somatosounds)," Carlos Herraiza and José Miguel Aparicioa, Unidad de Acúfenos; Instituto ORL Antolí-Candela, Madrid, Spain; Unidad de Otorrinolaringología, Fundación Hospital Alcorcón, Madrid, Spain; Otorrinolaringología, Hospital Quirón, Madrid, Spain, Acta Otorrinolaringol Esp. 2007;58(9):426-33. This is a link to the article abstract.

Article: "How I Struggled with (PULSATILE) Tinnitus," The Story of Actor Graham Cole, Daily Mail Online, January 10, 2007.

Article: "I Got Lifesaving OP for Whooshing Thanks to US Help," David Powell, Daily Post UK, DPW West, Feb 19, 2013.

Article: "Vital Signs: An Unwelcome Ringing," by Dr. Christopher Linstrom, Discover Magazine, April 2010. (About a cured patient with pulsatile tinnitus symptoms!)

Article: "Tinnitus Highlights Poor Doctor Patient Communication," Martin Young, MBChB, FCS(SA), Diagnosis and Treatment, KevinMd.Com, November 2010.

Article: "Pulsatile Tinnitus: Recent Advances in Diagnosis," Aristides Sismanis MD, Wendy R. K. Smoker, MD, The Laryngoscope, Volume 104, Issue 6, pages 681-688, June 1994. ABSTRACT (Summary)

Article: "Neuroradiologic Assessment of Pulsatile Tinnitus," Department of Otolaryngology Head and Neck Surgery Loyola University Medical Center, Maywood, IL: Dr Kircher and Dr Leonetti; Department of Otolaryngology-Head and Neck Surgery Henry Ford Health System, Detroit, MI: Dr Standring; Presented at the Annual Meeting of the American Academy of Otolaryngology-Head Neck Surgery, Chicago, IL. Sept. 22-24, 2008. (CLICKING THIS LINK WILL DOWNLOAD THE PDF FILE)

Article: "Imaging of Tinnitus: A Review," Jane L. Weissman, MD and Barry E. Hirsch, MD, Radiology, August 2000.

Article: "Imaging in Pulsatile Tinnitus," G. Madania and S.E.J. Connor, Clinical Radiology, Volume 64, Issue 3, Pages 319-328 (March 2009).

Article: "Imaging of the Patient With Tinnitus," Mary Beth Cunnane MD, Massachusetts Eye and Ear Infirmary, December 31, 2013. (NEW! Mentions Whooshers.com and PULSATILE tinnitus as well.)

Article: "Imaging of Pulsatile Tinnitus: A Review of 74 Patients," Guner Sonmez, C Cinar Basekim, Ersin Ozturk, Atilla Gungor, Esref Kizilkaya, Clinical Imaging, Volume 31, Issue 2, Pages 102-108 (March 2007). (This is an abstract/summary-you have to pay to see the article in its entirety)

Article: "Pulsatile Tinnitus: A Review of 84 Patients," Daniel Waldvogel, Heinrich P. Mattle, Matthias Sturzenegger and Gerhard Schroth, Journal of Neurology, Volume 245, Number 3, 137-142, DOI: 10.1007/s004150050193, November 12, 1997.

Article: "Role of Angiography in the Evaluation of Patients With Pulsatile Tinnitus," Edward J. Shin, MD; Anil K. Lalwani, MD; Christopher F. Dowd, MD, Laryngoscope 110: November 2000. (PDF FILE)

Article: "Angioplasty and Stenting for Intractable Pulsatile Tinnitus Caused by Dural Venous Sinus Stenosis: A Case Series Report," Li Baomin, Shi Yongbing, and Cao Xiangyu, Dept of Neurosurgery, Chinese PLA General Hospital, Beijing.

Article: "CT Angiography as a Screening Tool for Dural Arteriovenous Fistula in Patients with Pulsatile Tinnitus: Feasibility and Test Characteristics," J. Narvid, H.M. Do, N.H. Blevins and N.J. Fishbein, American Journal of Neuroradiology 32:446-453, March 2011.

Article: "Brain Dural Arteriovenous Fistula (BDAVF)," Patient Information, www.NeuroAngio.org

Article: "Usefulness of C-Arm Cone-Beam Computed Tomography in Endovascular Treatment of Traumatic Carotid Cavernous Fistulas: A Technical Case Report," Sato, Kenichi MD, PhD; Matsumoto, Yasushi MD; Kondo, Ryushi MD, PhD; Tominaga, Teiji MD, PhD, Neurosurgery: August 2010 - Volume 67 - Issue 2 - p 467470.

Article (Abstract): "A Convenient Sonographic Technique for Diagnosis of Pulsatile Tinnitus Induced by a High Jugular Bulb," The American Institute of Ultrasound in Medicine, Minoru Nakagawa, MD, Norimitsu Miyachi, MLT and Kenjiro Fujiwara, MD, Department of Neurosurgery (M.N., K.F.) and Clinical Laboratory (N.M.), Kosei General Hospital, Hiroshima, Japan, J Ultrasound Med 27:139-140 0278-4297, 2008.

Article: "Surgical Treatment of the High Jugular Bulb in Patients with Ménières Disease and Pulsatile Tinnitus," V. Couloigner, A. Bozorg Grayeli, D. Bouccara, N. Julien and O. Sterkers, European Archives of Oto-Rhino-Laryngology Volume 256, Number 5, 224-229, DOI: 10.1007/s004050050146 (ABSTRACT)

Article: "Brain AVM," (arteriovenous malformation), MayoClinic.com

Article: "Chiari Malformation," MayoClinic.com

Article: "Ménière's Disease," National Institute on Deafness and Other Communication Disorders (NIDCD)

Article: "TMJ Disorders," MayoClinic.com

Article: "Anemia," American Society of Hematology, Hemotology.org

Article: "Pseudotumor Cerebri," (also called Benign Intracranial Hypertension) MayoClinic.com

Article: "Pulse-Synchronous Tinnitus," The Intracranial Hypertension Research Foundation

Article: "Coarctation of the Aorta," MayoClinic.com

Article: "Man Cured of Hearing His Eyeballs Move," www.bbc.co.uk, July 27, 2011. Superior Canal Dehiscence Syndrome (SCDS)

Article: "Diagnosis and Cure of Venous Hum Tinnitus," Laryngoscope, Chandler JR, 93(7):892-5, July 1983.

Article: (Abstract) "Sinus Wall Reconstruction for Sigmoid Sinus Diverticulum and Dehiscence: A Standardized Surgical Procedure for a Range of Radiographic Findings," Dr. DJ Eisenman, Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland; Otology Neurotology, 32(7):1116-9; September 2011.

Article: (Abstract) "Awake Embolization of Sigmoid Sinus Diverticulum Causing Pulsatile Tinnitus: Simultaneous Confirmative Diagnosis and Treatment," Park YH, Kwon HJ, Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea, Interv Neuroradiol. 2011 Sep;17(3):376-9. Epub 2011 Oct 17. (NEW!)

Article: "A New Therapeutic Procedure for Treatment of Objective Venous Pulsatile Tinnitus," Sanchez TG, Murao M, Medeiros HRT, Kii M, Bento RF, Caldas JG, et al. Int Tinnitus J. 2002;8(1):54-57.

Article: "Glomus Tympanicum," The New England Journal of Medicine, Volume 362:e66, Number 22, June 3, 2010.

Article: "Resolution of Pulsatile Tinnitus Following an Upper Mediastinal Lymph Node Resection," Wang YZ, Boudreaux JP, Campeau RJ, Woltering EA, South Med J. 2010 Apr;103(4):374-7.

Article: (Abstract) "Dissection of the Internal Carotid Artery After SCUBA-Diving: A Case Report and Review of the Literature," Franz Hafner, MD,* Thomas Gary, MD,* Froehlich Harald, MD,* Ernst Pilger,* Reinhard Groell, PD,w and Marianne, Brodmann* "Neurologist. 17(2):79-82, March 2011. (NEW!)

Article: "Carotid-Cavernous Sinus Fistula," Bobby S. Korn, M.D., Ph.D., and Kang Zhang, M.D., Ph.D., N Engl J Med 2011; 364:e15, February, 24, 2011. (WARNING: GRAPHIC IMAGES)

Article: "Pulsatile Tinnitus Cured by Mastoidectomy," Duvillard C, Ballester M, Redon E, Romanet P., Department of Otolaryngology-Head and Neck Surgery, Hôpital Général, Dijon, France, Ann Otol Rhinol Laryngol, September 2004.

Article: "Pulsatile Tinnitus: A Symptom of Chronic Subclavian Artery Occlusion," Marcio Francisco Lehmann, Charbel Mounayer, Goetz Benndorf, Michel Piotin, and Jacques Moret, AJNR Am J Neuroradiol 26:19601963, September 2005 (PDF).

Article: "Carotid Endarterectomy Relieves Pulsatile Tinnitus Associated with Severe Ipsilateral Carotid Stenosis," J Kirkby-Bott, H.H Gibbs, European Journal of Vascular & Endovascular Surgery, Volume 27, Issue 6, Pages 651-653, June 2004.

Article: "MR Angiography Imaging of Absence Vertebral Artery Causing of Pulsatile Tinnitus: A Case Report," *Mehmet Cudi Tuncer; **Yekta Helbest Akgül & *Özlen Karabulut,* Department of Anatomy, Faculty of Dicle University, 21280, Diyarbak¹r, Turkey.** Department of Otorhinolaryngology, Özel Diyarbakr Hospital, 21100, Diyarbakr, Turkey, International Journal of Morphology, v.28 n.2 Temuco Jun. 2010."

Article: "Endovascular Treatment of Sigmoid Sinus Aneurysm Presenting as Devastating Pulsatile Tinnitus. A Case Report and Review of Literature." Mehanna R, Shaltoni H. Morsi H, Mawad M., Interv Neuroradiol. 2010 Dec;16(4):451-4. Epub 2010 Dec 17.

"Pulsatile Tinnitus Caused by an Aneurysm of the Transverse-Sigmoid Sinus: A New Case Report and Review of Literature," Lenck S, Mosimann PJ, Labeyrie MA, Houdart E., Department of Neuroradiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France, J Neuroradiol. 2012 Oct;39(4):276-9. doi: 10.1016/j.neurad.2012.02.001. Epub 2012 Sep 29. (NEW!)

Article: "Intractable Tinnitus and Sensorineural Deafness Cured by Surgical Correction of Coarctation of Aorta," S. Rathinam, A.M. Pettigrew, J.C.S. Pollack, Interactive Cardiovascular and Thoracic Surgery 3:431-433 (2004).

Article: "Pulsatile Tinnitus," Don McFerran FRCS Consultant Otolaryngologist Essex County Hospital, Colchester, British Tinnitus Association, October 2007.

Article: "Pulsatile Tinnitus and Dural Arteriovenous Malformation (Dural AVM)," G. A. J. Morrison, The Journal of Laryngology & Otology (1989), 103:1073-1075 Cambridge University Press (ABSTRACT).

Article: "Medical Mystery: Giving Birth Didn't Ease a Woman's Dangerous Hypertenstion," Sandra G. Boodman, The Washington Post, October 17, 2011.

Article: "That Noise Wasn't Just Tinnitus," Sandra G. Boodman, Special to The Washington Post, July 7, 2009

Article: "What's That Noise In Her?" H. Lee Kagan, Discovery Magazine, January 2006. (About a patient with arteriovenous malformation (AVM) and her doctor whose patience and persistence paid off).

Article: "The 'Rare' Disease That Isn't," Thomas M. Burton, The Wall Street Journal, June 27, 2009

Article: "Diseases and Conditions/ Fibromuscular Dysplasia (FMD)," Cleveland Clinic. Lists symptoms, details, treatments, and resources including Whooshers.com.

Article: Unraveling Pulsatile Tinnitus in FMD: A Report of the United States Registry For Fibromuscular Dysplasia."

Video: "A Rare Disease That May Be Underdiagnosed," Thomas M. Burton, June 26, 2009 (Hear an example of a whooshing sound in this short video)

Whooshers.com Pulsatile Tinnitus Sounds (Real Ones Recorded by Real Whooshers!)

Audio: Having trouble describing the sound you hear to others? Listen to this collection of sounds that whoosh and see if you can find a match to yours! Demonstrations: Heart Sounds & Murmurs, from the University of Washington Department of Medicine

Audio: FREE White Noise from White Noise MP3s.com

Audio: SimplyNoise.com

SleepPhones - pajamas for your ears (soft comfortable headphones for sleeping)

Whooshers.com Review: SleepPhones- Soft, comfortable headphones to help mask the whoosh for a good night's sleep.

Click Here for the International Association for Suicide Prevention (IASP)

Replace "ringing" with "whooshing," and here it is: our theme song.