My Tinnitus Went to Pulsatile Tinnitus and I'm Getting Scared

Hi, my first post here. I thought my tinnitus that started in 2016 was bad enough but now I have pulsatile tinnitus which started in February 2019. I am scared because I am beginning to think it might be vascular related. I don't know what might have triggered it.

Over the last 6 months I experienced by dad dying and mom having a stroke so maybe stress?
During this period I gained about 25 pounds.

I am going to have contrast CT scan Wednesday.

It is just scary hearing your heartbeat in your left ear every morning.

Also I noticed I have a bad tooth in the back that needs to be pulled. It is on the same side as of the ear that gets the pulsatile tinnitus. Maybe related?

Anybody have any thoughts or suggestions as what I can do next?

I live on the NH/MA line if anybody knows of any good doctors that might help.

 

Do you still have the normal tinnitus too, or only the pulsatile tinnitus?

 

Both,right now it though the pulsatile tinnitus sounds louder because I can really hear my heart beat.

 

Many cases of pulsatile tinnitus can be traced to stenosis - most commonly the traverse and sigmoid sinuses as in this picture. It's may or may not have been caused due directly with a bad tooth, but as seen from this picture these arteries past down the side of the face which can tense from hypertension.

In association to some, a tooth if may be pulling of the lateral pterygoid muscle with stretching or cervical hyperextension as both of these mechanism are the primary cause of TMJ that can lead to teeth problems.

There are other arteries in the sides and back of the neck that also have blood flow input association. Hyperextension of neck, face and shoulders muscles from stressful spasms due to hypertension can cause PT, but often it involves the C1 and/or other discs.

It's possible for some to have joint space narrowing, sclerosis, flattening and osteophyte formation at the medium atlantoaxial joint where therapy may help. Some also have a steep mandibular plane and the palatal vault may be deep. Be careful with hyperactive movement and maybe the PT will resolve.

The most common cause of idiopathic intracranial hypertension - head to pillow hum - PT - is poor posture. It called biomechanical intracranial hypertension (Larsen 2018b). The reason for this, is that droopy shoulders may often lead to compression of the artery (SA) (weak and tight scalene may as well). Distal SA obstruction will force blood redirection toward the carotid and vertebral arteries, thus saturating the cerebrovascular system. As a second but perhaps more important problem, is that hinge-neck postures, Atlas and migraine may cause blockage of the internal jugular vein, which is the main venous drainage from the cerebrum. This may occur as the vein is blocked between the styloid process of the cranium and the transverse process of the C1 (Larsen 2018b, Gweon 2011, Dashti 2012, Higgins 2015), and/or wrapped around the transverse process (TP) (Flanagan 2014) as the patient hyperextends their head in posture with being hypertense. Jayaraman et al. showed that extracranial IJV obstruction was coincidentally present in 33% of came into their department for angiography (the latter being negative, and the patients were deemed healthy), indicating that its prevalence is much higher than anticipated. Either way, drainage will be impaired, and the pressure will build up. More so, if the subclavian artery is obstructed as well. Increased inlet yet obstructed outlet is a recipe for intracranial hypertension, and may result in many maladies, some of which being endolymphatic hydrops, vhttps://patient.info/doctor/vertebrobasilar-occlusion-and-vertebral-artery-syndromeertigo, chronic fatigue, migraine, tinnitus, pulsatile tinnitus - hums, drums or heartbeat - maybe like a generator running, (Corbett 1982, Jayaraman 2012).
Your problem may have been caused by mechanical hypertension.

 

Yes,my posture became reslly bad these last few years do to new living and working conditions.

 

My biggest concern is I hope it is no bad blood flow problem which could lead to something more serious?
Should I see a special doctor for blood flow problems?

 

@SCOTTM grew up in your area and had the same experiences that you had with family and physical. Let's see what your tests show. Other tests like complete cervical ultrasounds may be needed that would involve thyroid testing. There are treatments for almost everything can could relate to what has taken place.

In the meantime be gentle with your neck. If you get dental work done, make sure that your head rest firmly on the head rest and don't lift your head off the headrest while pressure is being placed to the jaw and mouth. Also ask the dentist for short brakes to be able to relax your jaw by closing mouth. You may also want to give your jaw some support in the dental chair by using your hand. All of this will control artery blood flow and this is very much needed so to not develop PT or make it worse.

 

Thank you for the tips.
I will let you all know the results of the CT scan I have this week.

 

Sorry for the long delay, but after many mri/mras and a cat scan it was discovered I have a unruptured brain aneurysm. It is 1 mm so very small. They want to monitor it in 6 months What is strange though is the pulsatile tinnitus is in my left ear, while the brain aneurysm is behind my right eye. So if anybody has any suggestions if this brain aneurysm is connected to pulsatile tinnitus I would be interested in any ifo? They told me there is a 1 percent chance of rupture and they don't suggest surgery now.

 

Also they discovered mild atherosclerosis during a neck scan with contrast.

 

Not to mention I have also discovered I have high cholesterol and prediabetic . Looks like age is getting to me(early 50s). They recommend a major diet. I need to lose 50 pounds.

 

I would have thought so and was about to comment as to this possibility just before your last post. Your unruptured brain aneurysm may be from development of irregular blood flow in the vertebral artery. This could have happened from a brief moment of neck movement with hypertension - a quick rise in blood pressure. Aneurysms either in the brain, with neck arteries or an abdominal aortic aneurysm can be caused from hypertension - with neck physical tension. The problem with MRIs or MRAs - is that it's hard to view the vertebral artery. PT is probably from atherosclerosis, internal carotid and/or vertebral artery. Have you had an ultrasound done within your abdomen areas?

 

No Ultrasound. How would I get my doctor to get me one or should I use Life Line Screening?

 

Tinnitus and Pulsatile Tinnitus are not related or similar in any way. One can't turn into the other. MRI and MRA should be the first line, with an carotid ultrasound being done if those don't find anything. Don't ignore your symptoms, as it can be dangerous, but it can also be benign. But make sure you get evaluated by a proper specialist, and not an ENT.

I started this post to help:

If You Have Pulsatile Tinnitus, Here's the First Thing You Need to Do to Get Answers and a Diagnosis

 

How would I get a neuro-interventional radiologist to look at me? Ask my regular doctor who does my annual physical check up?

 

Hi Greg, you are so knowledgeable about pulsatile tinnitus. Just curious, are you in healthcare?

 

I just want to say My Very Loud eeeeeeeeeeeee tinnitus, that blew straight up out of my ear.. Did Also change into Pulsatile, And now I have both. When the PT lowers I hear a low eeeeeeee. I was never scared of my PT because I gave it to myself.
I was laying on the bed on my right side with an ice pack laying on the left side of head. I stayed there for 20mins. When I got up the back of the right side of my head was filled with pressure. I didnt think anything of it, went to sleep wearing earplugs. Woke to a very loud T in my right ear. It stuck around for two weeks, wldve lasted longer if not for Ativan. Everything stopped for 24hrs. Then on the next day I woke to PT. That was 2016 and To this day it goes back n forth, I have always believed I caused it and never feared it.

 

An update with this is the ear that has the Pulsatile Tinnitus makes a noise when I touch it? I have told this to my ENT and there is never a answer.
Also at night as I try to sleep I have weird twitches like with my heart connected to my ear.
I am going to see a cardiologist Doctor this week.

 

There isn't likely to be a problem with your heart, if you aren't having chest pains, dizziness, etc. But if you'd like to get it checked out, an EKG won't hurt. What's most likely is you are hearing the blood flow near your ear in rhythm to your heartbeat. If there were a problem with your heart, you wouldn't be hearing it. What you are hearing is something that is literally near your ear.

 

Thanks for the info. Do you think that is why when I touch my ear it feels like a nerves feeling,but the other ear that is non-Pulsatile Tinnitus doesn't make sounds at all when I touch it?

 

I really don't know, but I experienced something like this when I had PT as well. If the blood flow in the area is affected, the nerves can be also. Along with the PT, one of the first symptoms I had was low frequency hearing loss as well (on the affected side). This resolved with treatment also.

 

@SCOTTM With your mention of scanning of both neck and head and with thoughts about your heart also having involvement is a start for finding cause.

So far:
- unruptured brain aneurysm - this may be from white matter due to hypertension. It does not appear like MS.
- mild atherosclerosis during a neck scan with contrast. Neck arteries usually need to be narrowed by >60% to cause PT, unless there's other input such as I discuss on May 13, above. This input includes twisting of neck and shoulders or forward extension of neck during hypertense monents.

I would consider an ECHO where you are hooked up to a color monitor. The examiner will track blood flow all the way up to your neck.

Then I would consider an ultrasound of your abdominal aortic to see if it has enlarged. So more, if you have blurred vision or find it difficult to pee. If your abdominal aortic has enlarged - this is where your PT is coming from. The question is hypertension cause, from just one hypertense crisis - a moment where blood pressure quickly suddenly raises and then settles back down in minutes. If hypertension events, otherwise with normal blood pressure happens, then the heart and adnominal aortic place pressure points to the internal jugular on one side and the often the carotid arteries. This can also cause increase aging white matter. You are a little young for an enlarged aortic - 8% of men at 65 have one, but pre hypertension can still be possible if you feel your heart/sound connected to ear.

Sometimes after laying down or after some sleep, it can be possible on occasion with laying on opposite side of PT to feel blood going from abdominal and heart area to throat and then neck and ears. I have over 100 professional links on just hypertension classifications of PT and physical damage that can happen from this. 2/3 of all with PT have stress issues and about 1/3 have some hypertension. This is why those with physical tinnitus get PT more than the norm. Hypertension can be treated with choices from a wide range of classifications.

Your regular tinnitus may have association to posture issues - possible vertebral artery and internal jugular input from hyperextension of neck - neck and head injury - with maybe also some pre hypertension input. A vertebral artery issue and nerves going to the ears can cause hearing loss and high pitched tinnitus. This is one of the few areas that physical tinnitus and PT can be part of the same book.

 

Haven't had that done yet,but will ask my GP in March when I see him.

 

I will ask the cardiologist this when I see him this week. Thanks for the suggestion.

 

Now days when I touch my good ear, it will hum, until I stand up and move about. If you're not dizzy or fainting, its just a normal part of life. Take some Dayquil and Benadryl for a month and see if it changes for the better.

 

This is terrible advice. Those are not mild drugs and are not meant to be taken for that long. Both act on the central nervous system.

 

It's more help than what doctors give nowadays.

 

Not if you go to the right doctors. My PT was diagnosed and cured.

 

I hope mine can be cured someday as well. You give us hope. I plan to try to see that doctor you recommended soon.