Neck Tinnitus: When to Seek Medical Attention - Otolaryngology

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Tinnitus, or the perception of sound without an external source, can be a concerning symptom, especially when accompanied by other neurological signs. In your case, the sudden onset of pulsatile tinnitus—where you hear a rhythmic sound that corresponds with your heartbeat—can be alarming, particularly given your concern about a potential stroke.

Pulsatile tinnitus can arise from various causes, including vascular issues, such as increased blood flow in the vessels near the ear, or changes in blood vessel structure. It can also be associated with conditions like hypertension, atherosclerosis, or even venous hums. In some cases, it may be benign, but it can also indicate more serious conditions, such as arteriovenous malformations or intracranial hypertension.

Given your description, where you mention that you can hear the sound more prominently on the left side and that applying pressure to the right side also produces a sound, it is essential to consider the following:
1. Neurological Symptoms: If you experience any additional symptoms, such as weakness, numbness, difficulty speaking, or changes in vision, these could indicate a more serious condition, such as a stroke. In such cases, immediate medical attention is warranted.

2. Duration and Changes: If the tinnitus persists or worsens, or if you notice any new symptoms, it is advisable to seek medical evaluation. Sudden changes in your auditory perception, especially if they are accompanied by other neurological signs, should not be ignored.

3. Medical Evaluation: A healthcare provider will likely perform a thorough history and physical examination, focusing on your neurological status and any other associated symptoms. Depending on the findings, they may recommend imaging studies, such as an MRI or CT scan, to rule out any structural abnormalities or vascular issues.

4. When to Seek Help: If the tinnitus is persistent, bothersome, or associated with other concerning symptoms, it is wise to consult a healthcare professional. Even if you do not have additional symptoms, the sudden onset of pulsatile tinnitus warrants a medical evaluation to ensure that there are no underlying issues that need to be addressed.

In summary, while tinnitus can be benign, the sudden onset of pulsatile tinnitus, especially with your history of pressing on the sternocleidomastoid muscle, should be taken seriously. It is always better to err on the side of caution and seek medical attention to rule out any serious conditions, particularly if you have any accompanying neurological symptoms. Your health and peace of mind are paramount, and a timely consultation with a healthcare provider can help clarify the situation and guide you on the appropriate next steps.