Some cases of pulsatile tinnitus are caused by a narrowing of one of the large veins in the brain (red circles). The narrowing, or stenosis, disrupts the flow of blood and can lead to the whooshing sound or other noises of pulsatile tinnitus.
Pulsatile tinnitus can be caused by problems in the arteries or veins of the head, neck, or both. A 2013 review of the current literature indicated that about 28 percent of pulsatile tinnitus cases were due to venous causes, 23 percent were arterial, 18 percent were arteriovenous, and 31 percent were due to other or unknown causes. More than half of the venous cases of pulsatile tinnitus were due to idiopathic intracranial hypertension (also called pseudotumor cerebri), which has recently been associated with venous stenosis.
Many cases of pulsatile tinnitus can be traced to stenosis in one of the large veins in the brain, most commonly the traverse and sigmoid sinuses. The narrowing of the veins causes a disturbance in the blood flow, contributing to the whooshing sounds of pulsatile tinnitus. A new clinical trial for pulsatile tinnitus shows great promise that inserting a stent to widen the veins will restore healthy blood flow and eliminate the symptoms.
Other conditions that can lead to changes in blood flow and result in pulsatile tinnitus include:
It is critically important to identify the underlying condition causing the pulsatile tinnitus; treating and resolving that condition is the key to ending the noise.
Reviewed by: Srikanth Boddu, MD, MSc
Last reviewed/updated: September 2023
Illustration by Thom Graves Creative, CMI