Happy Birthday, Dr. Egas Moniz - Creator of the Cerebral Angiography
Dr Moniz, Photo c/o NobelPrize.org
A little history of a man with a big vision:
Dr Moniz, a neurologist from Portugal, developed the cerebral angiography, the test that uses x-rays together with a contrast dye to observe blood flow in the veins and arteries in and around the
brain. He did this in 1927-1928! It was this approach that allowed doctors to detect abnormalities like never before, and
the technique is still used today. Many consider it the "gold standard" for diagnosis of cerebral vascular disease and assessment of "collateral" circulation. The test is invasive, especially compared to MRI/MRA and some other diagnostic tests that have since
been developed. But for some of us, including yours truly, it turns out to be the test - the only test - that determines the
underlying cause of pulsatile tinnitus.*
If he were alive, Dr Moniz would be 138 years old on November 29, 2012. His
full name was Antonio Caetano de Abreu Freire Egas Moniz and he was a pioneer. 1927 was a good year for pioneers... that
was the same year that the first transatlantic phone call was made via radio, and the year Charles Lindbergh made the first
solo nonstop transatlantic flight from New York City to Paris. So I suppose it shouldn't be a huge surprise that another man
decided to develop a method to view blood vessels inside and around the brain(!).
I've been a bit fascinated by Dr
Moniz and his pioneering spirit. I mean, not everyone wakes up with a new idea to visualize blood flow in the head. And that
wasn't even his only achievement. He won the
Nobel Prize in Physiology or Medicine in 1949, not for the cerebral angiography, but for development of frontal lobotomy. He also wrote scores of medical papers, was a professor of neurology and even became a politician in Portugal.
many pioneers, he died well before the full benefit of his research and work would be apparent to the medical profession;
it's still being realized. The technique, now more advanced and improved with the help of technology, is still used today
as a diagnostic tool, an interventional procedure and as a guide in surgical procedures that involve the brain.
Moniz died on December 13, 1955, at the age of 81.
Many doctors have written about his work and have used the procedure
to help their own patients. Indeed many patients have been helped -lives saved- as a direct result of his vision and the professional
and personal risks he took to achieve it. We often discuss here how patients have to be their own best advocates, but
just as important are the doctors who are so dedicated to their profession and skilled that they think beyond the present,
the norm and themselves.
For an excellent (and daunting!) overview of Dr Moniz and his quest to develop the cerebral
angiography procedure, click and download
this file. It's worth reading!
I'm glad you were born, Dr Moniz!
*The cerebral angiography
is an invasive test. Discuss the benefits and risks with your doctor.
Wed, November 28, 2012 |
Cured Whoosher: Aneurysm of Transverse Sigmoid Sinus Cured via Endovascular Procedure
A recent report written by a group of doctors in Paris, France describes a 28-year-old woman with "disabling pulsatile
tinnitus." The cause - aneurysm of the transverse sigmoid sinus - was identified on a CTA, a non-invasive test. She had
an endovascular procedure and her pulsatile tinnitus was cured. No more whooshing! There aren't may details in
the abstract, but ask your doctor to look for the report in its entirety.
another report written just 12 years ago, this cause and treatment was considered "newly discovered." One of the doctors
who wrote the 2000 report also participated in the most recent report.
We've highlighted several other reports on this cause and treatment. Since at least one of the doctors who wrote the recent report has written on at least one similar case in the past,
I'd be interested to know whether this hospital has followed previous patients who have been treated to report any positive
and/or negative effects of the coiling solution. It would be interesting for patients (and, obviously, their doctors)
considering this treatment today to know, from the patients' perspective, how they're doing now. This report published in 2010 (not that long ago!) out of Houston, Texas discussed another case of the same cause and treatment (successful,
too!). It discussed that, "To our knowledge, eight of such cases have been published, five of which were treated
surgically and three by endovascular approach. We describe one additional case treated successfully by endovascular coiling
and review the current data on this subject."
So, it looks like yet another successful case of endovascular treatment
of sigmoid sinus aneurysm can be added to the list. That's great news for this patient and Whooshers everywhere.
This new abstract (summary) will be added to the list of others on our
Cured Whooshers page. Also, be sure to see and share with your doctors the previous posts about this cause, with links to additional
case reports/abstracts here.
Many thanks to a fellow Whoosher on our
Facebook group page for finding this report and letting me know about it!
"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. "Aneurysm of a Dural Sigmoid Sinus: A novel Vascular Cause of Pulsatile Tinnitus," Houdart E, Chapot R, Merland JJ, Department of Neuroradiology and Therapeutic Angiography, Hôpital Lariboisière,
Paris, France, Ann Neurol. 2000 Oct;48(4):669-71.
"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. Sun, November 11, 2012 |
Use code WHOOSHERS for 10% off SLEEPPHONES orders NOV 23-30!
How did you learn about Whooshers.com?
Whooshers.com Promote Your Page Too
NEW: Click Here to Download the PDF, "Top Ten Pulsatile Tinnitus Tips for Doctors." Review it with your GPs and ENTs!
Diagnosis and Treatment of Pulsatile Tinnitus, Dr. Maksim Shapiro, NYU Neurointerventional Radiology Section, NYU Langone
Medical Center - neuroangio.org
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
Find a Neurotologist: American Neurotological Society (ANS) Membership Roster
Find a Neurointervention Specialist: Society of Neurointerventional Surgery (SNIS)- Click on "Doctor Finder"
Find a Neuro-Ophthalmologist: The North American Neuro-Ophthalmology Society (NANOS)
Site: Neuroangio.org - Your neurovascular education and information resource. Patient Information.
UCSF Pulsatile Tinnitus Clinic
Article: "Pulsatile Tinnitus: Differential Diagnosis and Radiological Work-Up," Sjoert A. H. Pegge, Stefan C. A. Steens, Henricus
P. M. Kunst, and Frederick J. A. Meijer, Department of Radiology and Nuclear Medicine, Radboud University Medical Center Nijmegen
and Department of Otorhinolaryngology, Radboud University Medical Center Nijmegen, The Netherlands. (SEE TABLE 1).
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,
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
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, Otol Neurotol.
35.366-370. Dec 2014.
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,
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
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
Whooshers.com Review: SleepPhones- Soft, comfortable headphones to help mask the whoosh for a good night's sleep.