Pulsatile Tinnitus: Is It Linked to Blood Vessel Abnormalities?

Q: Pulsatile Tinnitus: Is It Linked to Blood Vessel Abnormalities?

Hello： Based on your description, tinnitus can be classified into two types： 1. <br>Subjective tinnitus, which can only be perceived by the individual, primarily caused by issues with the auditory system. <br>2. <br>Objective tinnitus, which can be perceived not only by the indiv

Pulsatile tinnitus

I remember experiencing a high spike in blood pressure once, and since then, I've been hearing a tinnitus sound that matches the frequency of my pulse.
Could you please advise if this is significantly related to abnormalities in the blood vessels of the brain?

Hua, 30~39 year old female. Ask Date: 2020/05/18

Dr. Jiang Junyi reply Neurology

Hello: Based on your description, tinnitus can be classified into two types: 1.
Subjective tinnitus, which can only be perceived by the individual, primarily caused by issues with the auditory system.
2.
Objective tinnitus, which can be perceived not only by the individual but also detected by others using instruments such as a stethoscope or phonocardiogram.
Objective tinnitus is not related to the auditory system itself but is mainly caused by factors such as vascular or muscular contractions.
Among these, myogenic tinnitus does not have a specific rhythm and is primarily caused by muscle contractions, such as spasms in the muscles of the middle ear, nasopharynx, and jaw.
Pulsatile tinnitus, on the other hand, has a rhythm that is synchronized with the heartbeat, and its mechanisms are mainly due to changes in the vascular wall and blood flow velocity.
The pulsatile tinnitus you mentioned can be categorized into two causes: (1) the generation of abnormal sounds—sounds that should not normally be present, caused by vascular malformations, such as arteriovenous malformations, vascular tumors, etc.
(2) amplification of normal sounds—sounds that already exist but have become louder due to certain factors, making them audible to the patient.
For example, when a patient experiences increased cardiac output, such as in hyperthyroidism, anemia, or pregnancy, these normally quiet "venous hums" can become louder and be heard.
Your symptoms appear to be more pronounced during times of stress and elevated blood pressure, which likely indicates amplification of normal sounds.
I recommend discussing examination and treatment options with a neurologist.
Wishing you good health, peace, and happiness.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2020/05/18

More Info

Pulsatile tinnitus is a type of ear ringing that is often perceived in sync with the heartbeat. This condition can be quite distressing and may lead individuals to wonder about its underlying causes, particularly concerning blood vessel abnormalities.
To answer your question, yes, pulsatile tinnitus can indeed be linked to blood vessel abnormalities. The sound you hear is typically caused by blood flow changes in the vessels near the ear or within the ear itself. When blood vessels are narrowed, enlarged, or otherwise altered, the flow of blood can create turbulence, which may be perceived as sound. This is particularly true in conditions such as arteriovenous malformations, vascular tumors, or even high blood pressure, which can affect the blood flow dynamics in the head and neck region.

High blood pressure, as you mentioned, can lead to increased blood flow velocity, which may contribute to the perception of pulsatile tinnitus. When blood pressure rises, the heart pumps more forcefully, and this can create a louder sound that resonates in the ear. Additionally, conditions like atherosclerosis, where arteries become narrowed due to plaque buildup, can also lead to turbulent blood flow, resulting in similar auditory sensations.

Other potential causes of pulsatile tinnitus include:
1. Vascular anomalies: Abnormal connections between arteries and veins can create unusual blood flow patterns that may be audible.

2. Middle ear conditions: Issues such as otosclerosis or Eustachian tube dysfunction can also contribute to the perception of pulsatile tinnitus.

3. Intracranial hypertension: Increased pressure within the skull can affect blood flow and lead to pulsatile tinnitus.

4. Tumors: Certain tumors, particularly those affecting the blood vessels or the auditory system, can also cause this type of tinnitus.

If you are experiencing pulsatile tinnitus, especially following episodes of high blood pressure, it is essential to consult with a healthcare professional. They may recommend imaging studies, such as an MRI or CT scan, to evaluate the blood vessels in your head and neck for any abnormalities. Additionally, a thorough examination of your cardiovascular health may be warranted to rule out any underlying conditions that could be contributing to your symptoms.

In summary, pulsatile tinnitus can indeed be linked to blood vessel abnormalities, and conditions such as high blood pressure can exacerbate this phenomenon. It is crucial to seek medical advice to determine the underlying cause and appropriate management strategies. Early intervention may help prevent potential complications and improve your quality of life.

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