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Pulsatile Tinnitus – What The???

Pulsatile Tinnitus is defined by the perception of some kind of noise in the ear as accompanying the heart beat and hence, the pulse. In other words, a persistent sound that beats in time with your pulse.

A quick and sure-fire way to check for Pulsatile Tinnitus is to simply check your pulse whilst listening to the beat of your tinnitus. If the two match up then you have Pulsatile Tinnitus. Simple!

This tinnitus variant is a little different in so far as there is a physical source. The source of the cause is the blood flow in the head area. Specifically, the changing of blood flow in arteries or veins near to or in the ears.

In order to get rid of it, you’re first going to need the right diagnosis and resulting treatment.

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Causes Of Pulsatile Tinnitus

As we said, Pulsatile Tinnitus is a result of the ears “hearing” blood flow. And, specifically, changes in blood flow in blood vessels near to the ears. It’s never that simple though. There are actually a number of differing specific causes.

Generalised Increased Blood Flow

This is usually completely normal and due to situations or activities which naturally stimulate a general increase in blood flow throughout the body. These triggers could include pregnancy, excitement, exertion  or exercise amongst others and for example. Anything that you’s associate with “getting the heart pumping”!

This still needs to be checked as certain medical conditions can also be the cause of the general increase in blood flow. Conditions such as anaemia or thyroid problems for example.

When the blood flow is increased it makes more noise and it’s this that results in the pulsating sounds associated with this condition.

Localised Increased Blood Flow

If the increase in blood flow is localised to the head area it is likely caused by abnormal blood vessels which have developed or are developing as a result of a localised medical condition. This needs checking out too as it could be resulting from a tumour (most often benign though), some form of head or neck trauma or blood vessel birth defect.

There’s also a specific condition known also to result in Pulsatile Tinnitus amongst its symptoms. That condition is called benign or idiopathic intracranial hypertension which results in high pressure in the space around the brain and spinal chord which in turn increases the localised blood flow.

Turbulent Blood Flow

Any hardening of or damage to the arteries creates an uneven blood vessel. This in turn results in an irregular or  “turbulent” blood flow which is obviously going to be louder than the normal smooth flow.

Heightened Awareness

There is an alternative cause of Pulsatile Tinnitus which is not caused by a change in blood flow. Instead it’s caused by an increased awareness of the sounds of normal blood flow. For a variety of medical conditions it’s possible to become more sensitive to and aware of normal blood flow noise. The brain would usually ignore these sounds but any heightened awareness equals Pulsatile Tinnitus!

These medical causes are usually related to hearing or ear conditions. Conditions such as a perforated eardrum, some form of ear infection, a retention of fluid in the ear, glue ear or such like.

Diagnosis Of Pulsatile Tinnitus

Pulsatile TinnitusIt’s important that you always check out Pulsatile Tinnitus to establish the cause and enable effective treatment. Diagnosis is usually not too difficult and starts with questions to build up an accurate case history, an internal examination of the ear canal and drum and a check of the pulsating sounds around the head and neck using a basic stethoscope. The stethoscope test will establish if the Pulsatile Tinnitus is subjective (can’t be heard) or objective (real and can actually be heard).

A hearing test may also be carried out.

In many cases these tests will be all that’s needed but any further concerns and the patient will be referred for medical imaging using an MRI or CT scan to check for any blood vessel abnormalities.

Pulsatile Tinnitus Treatment

This very much depends on the cause of the condition. Any medical condition will be specifically treated and is completely dependent on the condition.

If no specific medical condition can be diagnosed as the cause then it’s going to be a question of establishing the optimum tinnitus management program such as:

  • Sound Therapy.
  • Relaxation Therapy.
  • Cognitive Behavioural Therapy (CBT).
  • Tinnitus Counselling.
  • Meditation.
  • Tinnitus Retraining Therapy.

Hypnosis helps too – and there’s a great program to check out. It’s entitled simply Tinnitus Treatment Self-Hypnosis. Apart from being highly effective at less that $15 it’s not going to break the bank either.

Pulsatile Tinnitus – Important

As briefly and (hopefully) simply explained above the causes of Pulsatile Tinnitus are pretty wide ranging. They can often be as a result of a specific medical issue. Effective treatment is obviously and completely dependent on the specific and diagnosed cause. For these reasons it’s absolutely vital that you get checked out by a medical professional.


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    • Hulda
    • January 25, 2012

    I had pulsate tinnitus now for over 10 years. Its very annoying. In my opinion it was caused by medication, which I actually did not need. I was told that I had congested heart failure, so my doctor put me on Ramipril, after about 5 days I woke up at night with pulsate tinnitus very fast and loud, high blood pressure, got taken to emergency. Doctor changed medication, but got no relief. After seeing the cardiologist, was told that I had not congested heart failure. Still on medication for high blood pressure. My pulsate tinnitus never went away. I am listening to music especially at night when I am awake.

    • Doris Skinner
    • February 10, 2012

    Hello Doctors.
    The last couple years, I have been dealing with a mild ringingtone off and on. At first, it started with a mild pounding in the head then it has progressed to a ringingtone over a year ago. As of yet, no medication has been given for this mild pain. This past Thanksgiving, I went out of town and during that time my ringingtone has been nonstop only in one ear. In the past, it was mostly at night when it was quiet that I observed the noise. Eventhough, I have seen a couple of ear specialists but no conclusions data yet. My biggest statement is if something is wrong please let it be corrected at an early stage. I have some buddies who knew something was wrong in their bodies but the doctors “said they were fine but they were not”.

    • irene doherty
    • March 17, 2012

    My son has had p s for over ten year and lives on pain meds it has changed his life but no body seems interested in a diagnoses .I firmly believe it is caused by vessel malformation please help him !!!

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We are NOT medical professionals - if you are concerned about hearing problems or tinnitus you should always seek professional, medical advice.