Q. I have been experiencing pulsatile tinnitus, accompanied by chronic migraines. Please help.

Answered by
Dr. K. Murali
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 13, 2021

Hi doctor,

I am a 25-year-old male who is an athlete, never smoked or used any drugs or alcohol. No medical history. For the past year, I have been experiencing pulsatile tinnitus (a whooshing blood flow sound in sync with my heartbeat, in my ears, or head). It is also accompanied by chronic migraines at the base of my skull, slightly to the right side. The whooshing noise is more severe when I suddenly bend over or stand up, much worse while laying down than standing as well, especially when laying on my stomach with my neck upwards. The whooshing noise does not stop when I compress any arteries in my neck. The whooshing is intermittent and bilateral (both ears). When I hear loud or harsh noises of certain frequencies, I also experience strong spasms in my ear that are a sort of broken speaker echo response to the noise. I have had a lot of imaging done (MRA/MRV/MRI/CT/CTA), and the only things they have found have been:

Right vertebral artery that terminates in PICA.

Developmental venous anomaly of the right parietal lobe.

Are either of these two abnormalities serious, and would either of them be causing these symptoms? What do you think could be causing this?

Thank you.



Welcome to

The findings you have described do not usually cause any problems you have now:

Vertebral artery ending as PICA (posterior cerebellar artery syndrome) is a normal variant.

Developmental venous anomaly is also asymptomatic. If there is an associated cavernoma in the same location, there are risks.

For your symptoms other than ENT causes, the following conditions such as dural AV fistula, venous stenosis, or aneurysm need to be excluded. Your MRI or CT would have picked them.

Be under regular follow-up.

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