Pulsatile Tinnitus: When to Seek Further Evaluation

Q: Pulsatile Tinnitus: When to Seek Further Evaluation

Hello： You mentioned "brain MRI? Can I find this examination at a health check-up center with self-payment?" Typically, MRI is available only at regional hospitals. <br>"Regarding the time to improve allergies, may I ask how many months should I wait before actively seeking the c

Please ask again?

Hello Doctor: A few days ago, I asked about experiencing a pulsating sensation in my ear when turning my head after being diagnosed, but it doesn't happen every time.
Sometimes I don't hear it at all.
You mentioned it could be an issue with the Eustachian tube and suggested improving my allergies, which I will start working on.
You also mentioned "self-paid MRI to check for intracranial vascular issues." Is this referring to a brain MRI? Can I find this examination at a health check-up center on a self-pay basis? Additionally, if the pulsating sensation in my ear decreases in frequency after improving my allergies (since I only feel the pulsating heartbeat sound when I intentionally turn my head, and I don't hear it when I don't turn my head, and sometimes I don't hear it even when I do turn), can I just monitor it for now? If it worsens, should I seek further evaluation? To be honest, I feel pressured to go to a large hospital since I just had a baby and have no support.
How many months should I wait while trying to improve my allergies before actively seeking a cause if there is no improvement? I apologize for bothering you again, and thank you, Doctor.

Xingxing, 30~39 year old female. Ask Date: 2022/12/07

Dr. Jiang Junyi reply Neurology

Hello: You mentioned "brain MRI? Can I find this examination at a health check-up center with self-payment?" Typically, MRI is available only at regional hospitals.
"Regarding the time to improve allergies, may I ask how many months should I wait before actively seeking the cause if there is no improvement?" If there are no risk factors for hypertension or cardiovascular diseases, the progression of cerebrovascular diseases is usually slow, and clinical practice typically recommends reassessment after six months or more.
You are in a younger demographic, and if there were no significant issues during pregnancy and childbirth, there is no need to worry too much about cardiovascular problems.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi from Taoyuan Medical Center cares about you.

Reply Date: 2022/12/07

More Info

Pulsatile tinnitus is a unique type of tinnitus characterized by hearing a rhythmic sound that often coincides with the heartbeat. This condition can be caused by various underlying issues, including vascular abnormalities, changes in blood flow, or even ear-related problems. Understanding when to seek further evaluation is crucial, especially if the symptoms persist or worsen.

In your case, the sensation of hearing a heartbeat or a vibration when turning your head could indeed be related to issues with the eustachian tube or other ear-related conditions. Allergies can contribute to eustachian tube dysfunction, leading to pressure changes in the ear that may cause pulsatile tinnitus. It’s a good step to focus on managing your allergies, as this could potentially alleviate your symptoms.

Regarding your question about the MRI, when a physician refers to a "self-paid MRI," they typically mean a magnetic resonance imaging (MRI) scan that focuses on the brain and its vascular structures. This type of MRI can help identify any vascular anomalies, such as arteriovenous malformations or other blood vessel issues that could be contributing to your pulsatile tinnitus. Many health facilities, including diagnostic centers, offer MRI services, but it’s essential to confirm that they can perform the specific type of MRI needed for vascular assessment.

If you find that your symptoms improve with allergy management, it may be reasonable to monitor your condition for a few months. However, if you notice that the pulsatile tinnitus becomes more frequent or severe, or if you experience additional symptoms such as headaches, dizziness, or changes in vision, it would be prudent to seek further evaluation sooner rather than later.
The timeline for improvement can vary significantly among individuals. Some may notice changes within a few weeks of addressing their allergies, while others may take longer. It’s essential to listen to your body and be proactive about your health. If after a few months of managing your allergies there is no improvement, or if your symptoms worsen, it would be advisable to consult a healthcare professional for further evaluation.

In summary, while it’s understandable to feel overwhelmed, especially after childbirth and without support, prioritizing your health is crucial. Managing your allergies is a positive first step, and keeping an eye on your symptoms will help you determine when further medical evaluation is necessary. If you have any concerns or if your symptoms change, don’t hesitate to reach out to a healthcare provider for guidance. Your well-being is important, and seeking help when needed is a sign of strength.

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