Pulsating Vein Near Ear. Is This the Cause?

So I've noticed for years that I have this pulsating vein that can be felt behind my left ear. I can actually feel the vein there. I can also feel a pulse in the same spot on the right side, but it's not as strong and the vein isn't as close to the surface. Is it normal to feel a pulse/vein right behind the ear? I've researched this and am scared this could be a fistula.

It's also worth note that I only have PT when bending over and raising, and also when my heart rate increases with exercise. It only last 10-15 seconds and then I can no longer hear it. I've had this for as long as I can remember and always thought it was normal. When I'm at rest I do not have PT.

 

There's tons of blood vessels in the area, so it's very possible to have one close enough to hear it in sync with your heart beat.
I have the same symptoms as you: I hear it with a certain head position, and after I exhale.

Why are you thinking of a fistula? I don't see the link between your symptoms and a fistula.

 

I guess the reason I'm thinking fistula is because I feel a pulse and vein behind my ear and I feel like that's not normal. I was under the impression a fistula that would cause pulsatile tinnitus is usually behind the ear. Obviously, I hope I'm wrong but that where I developed the link in thinking it could be a fistula.

Of note, It's not really a whooshing sound but more of a "thud, thud, thud" when I hear it.

 

OK.
I have the same thud sound (it's not a woosh either).

 

Do you have orthostatic hypotension? I'm having similar issues, and this is one of the things I originally had some manifestation of. Try to monitor your blood pressure when straining or getting up fast and see what it's doing; it may have a connection to your PT (if you have access to a blood pressure machine.)

If you do not have constant dizziness of some type, constant headache and migraine symptoms (and I mean they do not go away and especially get worse with activity), or some kind of nystagmus, you likely do not have a fistula. I would still go to a neurotologist to rule it out, however. I'd also frankly be careful with your weightlifting for a while.

If anything I think your problem is vascular, most likely. Could be the reason for your sudden hearing loss as well back in the day. Is your heart in good shape and have they looked at the blood vessels in your head and neck?

 

I've had occular migraines since I was young. They come and go through spurts. Sometimes I can go months to a year without having one, other times I might get 2 in a week. I have over the past month been having some head pressure in the lower forehead area, mostly behind my eyes. Not debilitating or anything, just kinda there. I had a CT scan (with contrast) of my head 2 years ago when I had the hearing loss. They said everything came back normal. I had an echo of the heart in June which also came back normal. I do suffer from health anxiety and the past 6 months it's really reached new heights as I've been fearing I might have connective tissue disorder (which all the doctors I've seen think I don't). I've had multiple test done echo, CT of chest, and stress test ekg all in the last 6 months. All of which came back normal.

I don't know if this is my anxiety getting the best of me again or a warranted concern. Would you be able to physically feel a fistula and its pulse? Ironically, the head pressure I feel tends to lighten during exercise, but that's also when I hear the PT.

 

@sriggs3

I don't think you would be able to 'feel' a fistula, nor would there be a pulse. It's generally a really small (microscopic) tear to the round or oval window, which is why it is often diagnosed based on symptoms. In extreme cases, say the entire window was to implode, some people have claimed to feel or taste CSF going down their throat. But you would be bedridden if that were the case, and frankly I don't know if those accounts are true. If you additionally feel better standing up and moving then it cannot be a fistula; the inner ear fluid would be leaking out and you would feel terrible. That's why I never got diagnosed with a fistula.

I think it's something else. It could be that the migraines have spread to your ear (that's what I live with). Like I said previously it could be orthostatic hypotension or vascular compression of the auditory nerve. The latter is rare.

Did you have an MRI looking for anything?

 

Isn't a fistula an abnormal connection between a vein and an artery, almost like a bridge? Perhaps we aren't talking about the same thing or maybe there are different fistula's? I was referring to a dural arteriovenous fistula.

I either had an MRI or CT in 2014 when I had my sudden hearing loss. They wanted to make sure it wasn't cause by a tumor or anything. I can't really remember which one I had, I'm starting to this it was an MRI though. I remeber it was with cotnrast though.

 

@sgriggs3

No, ha, we were not talking about the same thing! I was thinking of a perilymph fistula, which happens in the inner ear. I don't know anything about that particular fistula you are referring to, unfortunately.

If they were looking for a tumor you would have had an MRI.

Do you get dizzy at all, and is your internal voice amplified?

Also, how do they diagnose a dural arterovenous fistula?

 

Yea then I must've had an MRI. I don't really get dizzy, just the head pressure but like I said I don't know if that just my anxiety or what.

As for diagnosing, I'm really not sure. I was hoping someone on here might now a little bit more about that.

@GregCA Do you know much about Dural Fistula's and how they diagnose?

 

@sgriggs3

Hmm, interesting. I get the pressure too. It may just be a migraine thing. Who knows maybe I have a fistula too?

Are your eyes doing ok and did they rule out retinal swelling? There is another little known condition called Benign Intracranial Hypertension which can cause pulsatile T, hearing loss, vision issues, and really bad headaches. The things you mention do affect intracranial pressure (bending over, etc.)
From what it seems by your symptom severity, however, you probably don't have this, or it is just a *really* mild case. It is generally a life threatening disease and it often eats up vision. Just curious though if this was ever considered.

 

No, I don't, but google gave me the answer: http://www.med.nyu.edu/radiology/ab...ur-services/brain-dural-arteriovenous-fistula

There's a section about diagnosis down the page.

 

Same here. Though I never had it before this whole nightmare started. For me, I had ETD, then headaches, then tinnitus, then pulsatile tinnitus, all on the right side. I'm beginning to think it was due to some neck injury on the right side. Must have inflammed tissue in the area near my Eustachian tube, causing the clogged right ear, tinnitus, and also pressing on blood vessels to make the blood flow turbulent. It might be a neck thing for you as well.