Clin Exp Otorhinolaryngol.  2012 Sep;5(3):170-172. 10.3342/ceo.2012.5.3.170.

Pulsatile Tinnitus as the Sole Manifestation of an Internal Carotid Artery Aneurysm Successfully Treated by Coil Embolization

• Kim DK
• Shin YS
• Lee JH
• Park SN

• KMID: 2134601
• DOI: http://doi.org/10.3342/ceo.2012.5.3.170

Abstract

Pulsatile tinnitus is tinnitus that coincides with the patient's heartbeat. It constitutes a small portion of all tinnitus, but it is often the first or sole manifestation of a serious disease in the nervous system. Aneurysm of the internal carotid artery is known as a rare cause of pulsatile tinnitus and, in the main, aneurysms of the petrous portion have been reported as a cause of pulsatile tinnitus. We present an interesting case of pulsatile tinnitus that was caused by a paraclinoid aneurysm in this report and discuss clinical features and treatment of paraclinoid aneurysm.

Keyword

Pulsatile tinnitus; Aneurysm; Carotid artery; Internal; Therapeutic embolization

MeSH Terms

Aneurysm
Carotid Arteries
Carotid Artery, Internal
Embolization, Therapeutic
Nervous System
Tinnitus

Figure

• 

  Fig. 1 Axial (A) and coronal (B) T2-weighted MRI shows a 1.4-cm signal void (arrow) in the paraclinoid region of the right internal carotid artery.

• 

  Fig. 2 Three-dimensional digital subtraction angiography of the right internal carotid artery shows a large saccular aneurysm arising from the paraclinoid segment.

• 

  Fig. 3 The angiography image after coil embolization of the aneurysm shows packed coil loops in the aneurysm (arrow) and well-preserved blood flow in the right internal carotid artery.

Reference

1. Waldvogel D, Mattle HP, Sturzenegger M, Schroth G. Pulsatile tinnitus: a review of 84 patients. J Neurol. 1998; 3. 245(3):137–142. PMID: 9553842.

2. Sonmez G, Basekim CC, Ozturk E, Gungor A, Kizilkaya E. Imaging of pulsatile tinnitus: a review of 74 patients. Clin Imaging. 2007; Mar-Apr. 31(2):102–108. PMID: 17320776.

3. Moonis G, Hwang CJ, Ahmed T, Weigele JB, Hurst RW. Otologic manifestations of petrous carotid aneurysms. AJNR Am J Neuroradiol. 2005; Jun-Jul. 26(6):1324–1327. PMID: 15956490.

4. Liu JK, Gottfried ON, Amini A, Couldwell WT. Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment. Neurosurg Focus. 2004; 11. 17(5):E13. PMID: 15633978.

5. Palacios E, Gomez J, Alvernia JE, Jacob C. Aneurysm of the petrous portion of the internal carotid artery at the foramen lacerum: anatomic, imaging, and otologic findings. Ear Nose Throat J. 2010; 7. 89(7):303–305. PMID: 20628987.

6. Hoh BL, Carter BS, Budzik RF, Putman CM, Ogilvy CS. Results after surgical and endovascular treatment of paraclinoid aneurysms by a combined neurovascular team. Neurosurgery. 2001; 1. 48(1):78–89. PMID: 11152364.

7. Kwon BJ, Im SH, Park JC, Cho YD, Kang HS, Kim JE, et al. Shaping and navigating methods of microcatheters for endovascular treatment of paraclinoid aneurysms. Neurosurgery. 2010; 7. 67(1):34–40. PMID: 20559090.