u/Realistic-Kiwi-3015

Hi, wrote the below as a comments to post, but wondering if there are ones with similar case…

My pulsatile tinnitus also started about 3 weeks ago. No trauma or anything obvious. I am M(48).

My symptoms:

1. ⁠Perfectly synchronized with my pulse
2. ⁠High-pitched, sounds like a seagull or kitten
3. ⁠Bilateral, both ears
4. ⁠Objective, meaning I could actually record it with my iPhone by placing the mic near the ear. It definitely helped get doctors’ attention, although objectively audible PT is not exactly a reassuring sign 😅 I uploaded the recording here for reference: https://on.soundcloud.com/HUR6C6BsSInRAuIj0N
5. ⁠At the beginning, pressing on the neck veins reduced/stopped it, but later it stopped responding to that
6. ⁠Valsalva maneuver (closing nose/mouth and pushing) reduced the sound a bit, but do not do it, it seems risky
7. ⁠Squatting down increases the sound, standing back up decreases it
8. ⁠In the morning the “seagull” sounds quieter and hoarse, like he smoked all night or something 😅 then later he comes back in full force

I had a CTA, MRI, and MRA of the brain. They found "meaningful" stenosis of the right intracranial ICA in the cavernous/C6-C7 segment. The good news is that the MRI showed no stroke or brain damage, and there is good collateral flow through the PCom, so at least I seem to have a decent backup route. they couldnt explain much the pitch and that it is on both ears, one proffesor had a theory about my skull structure or so...

I have already seen several doctors, including neurovascular specialists and interventional neuroradiologists. Right now the plan is basically medical treatment and follow-up imaging in about 6 weeks to see how things evolve.

They think it might be a dissection, but they are not sure. It could also be atherosclerosis. I already had a heart stent placed about 4.5 years ago... I'm on fire... 

My hope is that within 6 weeks it will either heal or at least stay stable. The scenario nobody wants is progression. Catheterization in this area is definitely not a walk in the park, so for now we wait and monitor.

At this point there is not much I can do besides trying to fucking relax :-)