Dizziness accompanied by Pulsitile tinnitus

[GMB]

I have been experiencing chronic pressure headaches accompanied by pulsitile tinnitus and dizzines for the last 2 months or so.  I experienced an increased amount of migraine headaches for about two months preceding this sudden ontake of symptoms (2-3 migraines a week).My general practitioner did initial bloodwork followed by an MRI.  These test have come back "negative."  My physician has reluctantly scheduled a follow-up visit.  I do not know what is going on with me medically, but I do know that my condition is becoming debillitating.  I am also having great difficulty concentrating and have short-term memory loss.  I have not been able to identify any causes for these symptoms.  They are persistent despite changes in diet, environment, weather conditions, and body position (sitting, standing, or lying down).  They do however seem to be aggravated by movement, including walking.
I am in desperate need of a diagnosis and treatment.  What tests should I ask my doctor to perform?  Should I see a specialist?

[CCF-Neuro-M.D.-JT]

A neurological consult with formal exam would be something to consider especially with the headaches. Pulsatile tinnitus can be caused by a number of things that are both neurological and non-neurological.  Some of the more common neurologic reasons include diseases of the arteries inside your brain or a tear of the artery in your neck. If this is a clinical possibility (especially if you have stroke/heart risk factors or had recent trauma to the neck),it can be evaluated with an MRA brain and neck, which is an MRI of the arteries. This is not routinely done with MRIs of the brain and have to be specially ordered. Another thought is atypical migraines. Non neurologic causes include anemia (low red blood count), thyroid disease, or other diseases that can cause increased blood to be pumped from the heart. If it's just tinnitus without the pulsatile feature, you may have a problem with the vestibular system (inner ear), in which case there are a number of causes such as infection. Start with a neuro referral. Let your PCP know how this is affecting your life. Good luck.

[okptcgal]

Hello,
I wanted to share with you my condition and see if you would see an opthamologist about your symptoms. I have what is called psuedotumor cerebri.. meaning false tumor in the head.. what it is is an increased spinal fluid pressure in the head . They do not know what causes this but it is debilitating. symptoms include. tinnitus, pressure headaches,sensitivity to light,neck pain , double vision,loss of peripheral vision,vertigo and many others.. I would suggest you see an opthamologist and they can look into the back of your eye to tell if you have any papilloedema(swelling of the optic nerve) which is a big factor in PTC. the only way they can tell whether or not you have PTC is by doing an LP (spinal tap). all of your mri's and things will show normal. medications that raise the intracranial pressure include those for acne such as tetracycline.. I would have a list ready for my doctor of what medicines you are currently taking.. I hope this helps you out..I hope you get the answers you are looking for..
okptcgal

[Enhanced Lesions on White Matter]

I wanted to tell you this. I went in for an MRI for the same reasons as you (pulsatte tinnitus, migranes etc..) My ENT Specialist ordered them to rule out blocked carotid artery. Turned out that was okay but my MRI showed plaques / lesions and that is how I found out I had Multiple Sclerosis.  Make sure your mri's were with and without contrast. Also you may want to ask for full head, brain stem and full spine MRI's.  

Good luck