This report, about a 37-year old man with pulsatile tinnitus, explores some of the pitfalls of evaluating our symptom.

Lucky for this patient, after a number of tests that returned "normal" results, doctors continued the evaluation and found that he had a carotid cavernous fistula. 

From Cedar Sinai, a carotid cavernous fistula is an abnormal connection between one of the two carotid arteries and the veins just behind the eye.

We don't really know from the article how this patient fared after the diagnosis, but the report describes the complexities often encountered when evaluating our cases. He'd been experiencing pulsatile tinnitus and vision issues for two years, saw a number of different specialists and endured multiple diagnostic tests that came back "normal" (sound familiar?).  

The article reinforces that many causes, like CCF, require the expertise of mulitple specialists. The report ends by telling us the patient's case was sent back to a neuro-opthalmologist.  

What's notable:

*The patient's pulsatile tinnitus, which he experienced for two years, did not change with head or neck manipulations.  

*The patient's initial tests showed "normal" results. 

The report also stresses what we already know:

"The sudden unilateral development of pulsatile tinnitus warrants a complete head and neck exam, audiogram, and imaging studies."  

Read the full journal article HERE.

Read more about CCFs HERE.

Sources: 

Symptom: Pulsatile Tinnitus, Djalilian, Hamid R., The Hearing Journal. 72(3):36,38,40, March 2019.  

"Carotid Cavernous Fistula, Cedars-Sinai. https://www.cedars-sinai.edu/Patients/Health-Conditions/Carotid-Cavernous-Fistula-.aspx 

Also, see the Cured Whoosher story posted on this site several years ago HERE and many other Cured Whoosher stories on the Cured Whooshers page.