BACKGROUND Pulsatile tinnitus(PT)is a potentially disabling symptom that has received increasing attention.Multiple causes of PT have been confirmed by targeted treatment.However,dynamic changes of related structures ...BACKGROUND Pulsatile tinnitus(PT)is a potentially disabling symptom that has received increasing attention.Multiple causes of PT have been confirmed by targeted treatment.However,dynamic changes of related structures in PT patients with multiple causes after stenting for ipsilateral transverse sinus stenosis(TSS)have not been previously reported.We report such a case and present postoperative computed tomography venography(CTV)follow-up findings to demonstrate the decreased sigmoid sinus diverticulum and bone remodeling.CASE SUMMARY A 45-year-old man suffered from left-sided PT for 15 years that was occasionally accompanied by headache and dizziness.Pre-operative CTV revealed left-sided sigmoid sinus wall anomalies(SSWAs),TSS,outflow dominance,large posterior condylar emissary vein,and an empty sella turcica.A cerebrospinal fluid pressure of 270 mmH2O was further detected.The sound disappeared immediately after stenting for ipsilateral TSS,with no recurrence during 2 years of follow-up.After the procedure,the patient underwent four consecutive CTV examinations.The diverticulum decreased 6 mo after the procedure with new bone remodeling.The density of the remodeled bone was further increased 1 year later,and a hardened edge was formed 2 years later.CONCLUSION PT associated with SSWAs,TSS,and idiopathic intracranial hypertension can be cured by stenting for TSS alone.And bone remodeling around SSWAs is a more significant finding.展开更多
BACKGROUND Pulsatile tinnitus(PT)is an annoying sound that can be eliminated with targeted treatment of the cause.However,the causes of PT have not been fully elucidated.CASE SUMMARY A 38-year-old woman with right-sid...BACKGROUND Pulsatile tinnitus(PT)is an annoying sound that can be eliminated with targeted treatment of the cause.However,the causes of PT have not been fully elucidated.CASE SUMMARY A 38-year-old woman with right-sided objective PT underwent preoperative computed tomography arteriography and venography(CTA/V).A 3.8 mm vine diploic vein(DV),which passed through the mastoid air cells posteriorly in a dehiscent canal and was continuous with the transverse-sigmoid sinus,was thought to be the causative finding.Four-dimensional flow magnetic resonance(4D flow MR)imaging showed that the blood in the DV flowed toward the transverse-sigmoid sinus.The closer the blood was to the transverse-sigmoid sinus,the higher the velocity.No vortex or turbulence was found in the DV or adjacent transverse sinus.The sound was eliminated immediately after ligation of the DV with no recurrence during a three-month follow-up.No flow signal of the DV was noted on postoperative 4D flow MR.CONCLUSION A DV may be a treatable cause of PT.CTA/V and 4D flow MR could be utilized to determine the morphological and hemodynamic characteristics of the DV.展开更多
基金The Beijing Scholar 2015and the National Natural Science Foundation of China,No.61931013,No.81701644,and No.61801311.
文摘BACKGROUND Pulsatile tinnitus(PT)is a potentially disabling symptom that has received increasing attention.Multiple causes of PT have been confirmed by targeted treatment.However,dynamic changes of related structures in PT patients with multiple causes after stenting for ipsilateral transverse sinus stenosis(TSS)have not been previously reported.We report such a case and present postoperative computed tomography venography(CTV)follow-up findings to demonstrate the decreased sigmoid sinus diverticulum and bone remodeling.CASE SUMMARY A 45-year-old man suffered from left-sided PT for 15 years that was occasionally accompanied by headache and dizziness.Pre-operative CTV revealed left-sided sigmoid sinus wall anomalies(SSWAs),TSS,outflow dominance,large posterior condylar emissary vein,and an empty sella turcica.A cerebrospinal fluid pressure of 270 mmH2O was further detected.The sound disappeared immediately after stenting for ipsilateral TSS,with no recurrence during 2 years of follow-up.After the procedure,the patient underwent four consecutive CTV examinations.The diverticulum decreased 6 mo after the procedure with new bone remodeling.The density of the remodeled bone was further increased 1 year later,and a hardened edge was formed 2 years later.CONCLUSION PT associated with SSWAs,TSS,and idiopathic intracranial hypertension can be cured by stenting for TSS alone.And bone remodeling around SSWAs is a more significant finding.
基金Supported by National Natural Science Foundation of China,No.61931013 and No.61801311.
文摘BACKGROUND Pulsatile tinnitus(PT)is an annoying sound that can be eliminated with targeted treatment of the cause.However,the causes of PT have not been fully elucidated.CASE SUMMARY A 38-year-old woman with right-sided objective PT underwent preoperative computed tomography arteriography and venography(CTA/V).A 3.8 mm vine diploic vein(DV),which passed through the mastoid air cells posteriorly in a dehiscent canal and was continuous with the transverse-sigmoid sinus,was thought to be the causative finding.Four-dimensional flow magnetic resonance(4D flow MR)imaging showed that the blood in the DV flowed toward the transverse-sigmoid sinus.The closer the blood was to the transverse-sigmoid sinus,the higher the velocity.No vortex or turbulence was found in the DV or adjacent transverse sinus.The sound was eliminated immediately after ligation of the DV with no recurrence during a three-month follow-up.No flow signal of the DV was noted on postoperative 4D flow MR.CONCLUSION A DV may be a treatable cause of PT.CTA/V and 4D flow MR could be utilized to determine the morphological and hemodynamic characteristics of the DV.
