Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
I have had pulsatile tinnitus in my right ear for a year, so I have had every test. Unfortunately, I do have a small hole in the semicircular canal. But now another maybe a problem. Through a CTV, it was discovered I have venous sinus stenosis. An angiogram report stated severe hypoplasia of the left transverse sinus. Does this mean the same thing? I have been checked for everything else and do not have intracranial hypertension. So is having severe venous sinus on my left side something to worry about?
Thank you.
Hi,
Welcome to icliniq.com.
Severe hypoplasia of the left transverse sinus means - the left transverse sinus is very small or not well-formed since the beginning (since birth or during development). It is a developmental anomaly and does not cause any symptoms. It should not be a reason for tinnitus.
Patient's Query
Hello doctor,
I have pulsatile tinnitus on the opposite site of congenital venous sinus stenosis. When I turn my head to the left on the side of stenosis, I get whooshing at times. I do not have intra-cranial hypertension. I also have BPPV from this. I get positional vertigo once a month. Do you think having this could eventually cause a thrombosis, destruction of the blood-brain barrier, or intracranial hypertension? Any thoughts you have, I would appreciate.
Thank you.
Hi,
Welcome back to icliniq.com.
The benign paroxysmal positional vertigo (BPPV) and positional vertigo can be due to issues in the semicircular canal. Pulsating tinnitus can be due to many mentioned causes like arteriovenous malformation, ear effusion due to any cause, glomus tumor, and raised intracranial pressure (ICP) even it has been seen without any detectable structural abnormality. But BPPV or pulsatile tinnitus will not cause thrombosis, blood-brain barrier destruction, or intracranial hypertension. I do not know how you ruled out benign intracranial hypertension. Routine computed tomography (CT) does not rule it out. You have mentioned CT venogram & angiogram only. I would suggest you get contrast-enhanced magnetic resonance imaging (CEMRI) brain too (if not done till now) and consult an ear, nose, and throat (ENT) specialist too. Also, get ophthalmologist examination for fundus examination.
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Neurology
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