Pulsatile tinnitus may be subjective (only the patient
can hear it) or objective (the patient AND others can hear it).
Sometimes objective pulsatile tinnitus can be heard with
Sometimes it can even be heard without a stethoscope, just by putting your ear next to the pulsatile tinnitus
It is repeated in the medical literature
that doctors should try to listen for the bruit (the sound) when a patient presents with pulsatile tinnitus. Sometimes
where the sound is located can be a clue as to the source. At the very least, hearing the sound gets the attention of medical
professionals and may speed up the inquiry as to the cause.
The right spot for the stethescope bell will vary by the patient, as the location of the source of the pulsatile
tinnitus differs from patient to patient.
a very helpful post with images from "Kate," one of the members of our very active Facebook group page, republished with her permission, on how to listen for the bruit with
"I made this to show where my bruit can be heard on my skull.
In December 2016
I was told by an ER doctor, when I asked him to listen to my skull,
"We don't listen there. There's nothing there
to listen to."
He would only auscult
my carotid on my neck and then told me my symptoms could be Meniere's or multiple sclerosis and they can't do much for
me except refer me to an ENT.
My personal experience/tips, as I am not a medical professional so I'm just
sharing what worked for me to find the objective noise:
The stethoscope is a pediatric stethoscope. The person I borrowed this from let me try their fancy top brand cardiac stethoscope
but the pediatric one worked best. It helps to press firmly but not too firmly. The sound volume changes with pressure.
I can find it easily but in noisy doctor offices it can be harder to hear and especially if the person listening just
quickly places the bell and moves it. It's louder in certain spots so patience and careful listening for at least 10
seconds in each spot is important in my opinion. Also, doing jumping jacks to make it louder helped my doctor the first
time to find it. The second time she didn't need me to do jumping jacks because she knew what she was listening for.
As Whoosh Whoosher has said, not everyone with PT has objective PT/bruit and the absence of one doesn't change the validity of your PT.
Docs should take all PT seriously. In my experience, finding the bruit just really helped as far as having them
take it seriously and sped up the process.
sure you check with different postures and head positions in case the whoosh varies by these factors. For example, mine is
usually silent/quiet/gurgly when laying flat, louder when tilting head to opposite shoulder of PT ear and quieter when
tilting head to PT ear.
I really think the important things are to have a silent place to listen, a patient listener,
and a good, smaller-sized stethoscope (which also helps very specifically locating the loudest point).
Other factors, once I found my whoosh, that I noticed influence the sound are things
like valsalva maneuver, holding breath, pressing artery/veins, etc. I've experimented with pressing on my carotid and jugular
on both sides as well as the blood vessel on the back of my neck which I think might be the occipital artery.
I am hoping this information will be useful for
the doctors and perhaps clue them to anatomical areas to focus on when looking at my scans."
Be sure to see the Sounds page on this site for more images and links to audio of real whoosh sounds, recorded by real whooshers!
Peter Mansfield, M.R.I. Pioneer and Nobel Laureate, Dies at 83
Sometimes it's easy to forget that we are indebted to some of the pioneers in medicine who take a chance and create something
that will endure their lifetimes and help more people than they ever could have imagined!
Sir Peter Mansfield, whose
research led to the invention of MRI, died February 8, 2017.
While an MRI can't detect each and every possible cause
of pulsatile tinnitus, it can detect many of them. A number of people in our community, including Yours Truly, are pretty
glad Sir Mansfield was born!
Read more about Sir Peter Mansfield's amazing life and discoveries here, from the New York Times.
We are conducting this survey to better understand
the impact that pulsatile tinnitus has on people's lives in terms of depression, anxiety, and function. We hope that this
information will help guide us in terms of providing better care for our patients and raising awareness of pulsatile tinnitus
as an illness.
Use code SILENTNIGHT for 25% off US orders of $50 or more. Includes free shipping. Using this link your order will
provide a portion of proceeds to our Whooshers.com community! Good through Friday, December 2, 2016!
is TRULY a fantastic development. So many of us have been assigned a "tinnitus" diagnosis code, when what
we experience is not tinnitus at all. Pulsatile tinnitus is not tinnitus. This is an important, validating
change, and, in some cases, it will be a life-saving change to the way our cases are documented. With a distinguishable code,
more medical professionals will research OUR symptom, recognize the complexities unique to OUR cases, and know better than
to tell us to "live with it" before ordering a thorough and appropriate medical evaluation.
keeping track, the codes are within Chapter 8 - Diseases of the ear and mastoid process. We know that the underlying
causes of pulsatile tinnitus go beyond diseases of the ear, and, in fact, most causes do not have anything to do with the
ear. However, I still think this is a positive development that will go to great strides to distinguish our cases from
regular tinnitus cases, resulting in quicker and more appropriate evaluation.
Hooray for Whooshers everywhere! Make
sure your doctors are aware of the new PULSATILE TINNITUS DIAGNOSIS CODES!
A story recently published by The Columbus Dispatch out of Columbus, Ohio, highlights a diagnosis and attempted treatment for pulsatile tinnitus. Unfortunately, the treatment
was not successful, however the story accurately identifies her symptom as *pulsatile* tinnitus and describes the frustrating
and, sadly, common quest many of us experience to achieve a diagnosis.
Her diagnosis, dural arteriovenous
fistula (DAVF) is one we have seen before. It is an underlying cause that can be dangerous if left untreated. According
to Johns Hopkins Medicine, DAVF is "an abnormal connection of vessels in the tissues around the brain or spinal cord in which one or more arteries
are directly connected to one or more veins or venous spaces called sinuses." Also, see this page for more info written for patients' understanding.
There are numerous medical reports and personal stories
about DAVF linked to on our Cured Whooshers page, including successful treatments.
This story is a reminder that each case is unique. Treatment can be complicated.
A diagnosis is only one step toward silence.
Like many in our community, this patient was her best advocate and
wouldn't take "live with it" for an answer. According to the story, she was seen by half a dozen specialists before
her underlying cause was identified.
Our community, especially those of us diagnosed with DAVFs, wishes this
patient the best during her recovery and her continued quest for silence! You're not alone!
As this story illustrates,
it's a big accomplishment to find the underlying cause of pulsatile tinnitus, but it is only half the battle.
Weill Cornell Medical College in New York Announces a New Clinical Trial for Pulsatile Tinnitus
The FDA and the Weill Cornell Institutional Review Board (IRB) have approved a new clinical trial for pulsatile tinnitus
at Weill Cornell Medical College in New York City. The study will specifically address cases of stenosis (i.e. narrowing)
of veins near the brain, most commonly the transverse and sigmoid sinuses.
Read more information about the new
clinical trial here.