Why does unilateral pulsatile tinnitus occur in patients with idiopathic intracranial hypertension?
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HEAD-NECK-ENT RADIOLOGY
Why does unilateral pulsatile tinnitus occur in patients with idiopathic intracranial hypertension? Pengfei Zhao 1 & Chenyu Jiang 1 & Han Lv 1 & Tong Zhao 2 & Shusheng Gong 3 & Zhenchang Wang 1 Received: 4 June 2020 / Accepted: 24 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate the relevant factors of unilateral pulsatile tinnitus (PT) in patients with idiopathic intracranial hypertension (IIH) using CT. Methods CT angiography images of IIH patients with unilateral PT (n = 19), without PT (n = 13), and controls (n = 32) were reviewed. The characteristics including transverse sinus stenosis (TSS), venous outflow laterality (VOL), sigmoid sinus wall dehiscence (SSWD), and sigmoid sinus diverticulum (SSD) were quantitatively or/and qualitatively detected. VOL was compared between the symptomatic side of IIH patients with PT and the larger side of IIH patients without PT and the controls. TSS, SSWD, and SSD were compared between the symptomatic side of IIH patients with PT, and both sides of the latter two groups. Results There was no statistical difference in body mass index or cerebrospinal fluid pressure between IIH patients with and without PT. The prevalence of TSS was significantly higher in IIH patients than that in the controls (p = 0.000), but TSS had no correlation with PT within IIH patients. The prevalence of SSWD successively decreased in IIH patients with PT, without PT, and the controls, with significant differences between each two of three groups (p = 0.000, p′ = 0.000, p″ = 0.031). The proportion of VOL and the prevalence of SSD were significantly larger in IIH patients with PT than in the latter groups respectively (pVOL = 0.005, p′VOL = 0.000; pSSD = 0.040, p′SSD = 0.000). All SSDs in IIH patients with PT were accompanied with SSWD. Conclusion The dominant VOL and ipsilateral SSWD with/without SSD may be correlated with the occurrence of unilateral PT in IIH patients. Keywords Pulsatile tinnitus . Idiopathic intracranial hypertension . Transverse sinus . Sigmoid sinus . Computed tomography
Introduction Vascular pulsatile tinnitus (PT) is a disturbing acoustic perception that synchronizes with the heartbeat [1]. It may seriously affect the sufferers’ life quality and psychosocial health PZ and CJ contributed equally to this work. PZ and CJ are co-first author. * Zhenchang Wang [email protected] 1
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95th Yong’an Road, Xicheng District, Beijing 100050, China
2
Department of Radiology, Beijing Shangdi Hospital, 6th, West Shucun Street, Haidian District, Beijing 100083, China
3
Department of Otorhinolaryngology - Head & Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95th Yong’an Road, Xicheng District, Beijing 100050, China
and cause functional and structural brain alterations [2, 3]. Idiopathic intracranial hypertension (IIH) has long been considered as one of the most common causes of PT, while PT is also ta
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