Vertigo Research Today is a free monthly online journal that collates and summarizes the latest research about Vertigo, including details on causes, symptoms, treatment, dizziness.

Post-traumatic pulsatile tinnitus: the hallmark of a direct carotico-cavernous fistula.

Lerut B, De Vuyst C, Ghekiere J, Vanopdenbosch L, Kuhweide R

Department of Otolaryngology, Az St Jan Hospital, Bruges, Belgium. boblerut@gmail.com

Following trauma to her right frontal region, a 68-year-old woman suffered bilateral, benign, paroxysmal, positional vertigo and a left-sided, longitudinal petrosal bone fracture, with secondary facial palsy and ossicular luxation. From the onset, the patient complained of pulsatile, left-sided tinnitus. After eight weeks, she developed left-sided ocular symptoms, progressing from conjunctival hyperaemia and orbital oedema to an abducens nerve palsy, and ultimately to heart failure. The case and the final diagnosis of carotico-cavernous fistula are discussed. Guidelines are proposed for a diagnostic approach to pulsatile tinnitus and for the optimal management of patients presenting with pulsatile tinnitus associated with ocular symptoms.

Published 26 October 2007 in J Laryngol Otol, 121(11): 1103-7.
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