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Objective Pulsatile Tinnitus with possible frontal lobe tumor or AVM
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Objective Pulsatile Tinnitus with possible frontal lobe tumor or AVM

In March 2008, I started hearing a whooshing noise in my right ear. It is a continuous, 24/7 sound in time with my heart beat. This began a few weeks after a very nasty ear infection so I let it slide for a while thinking that was the cause. I finally did see my primary doctor and was told that I had some fluid. When the noise continued, I saw my primary again and was told there was no fluid or infection, but to give it some time to clear up. I finally asked to see an Ear, Nose, and Throat specialist when the whooshing sound continued throughout the summer.

The first specialist I saw did some auditory tests and found a 40% hearing loss in the affected right ear (Lower decibels), but no anatomical problems in the ear itself. A test with a tuning fork showed that sound was louder in the ear affected by the tinnitus. He felt it might clear up on it's own, without knowing exactly what the problem was, so I was asked to wait six weeks. He didn't feel qualified to continue on (Very stumped), so at the end of the six weeks, he sent me to another specialist.

Within minutes, the second specialist determined it was objective pulsatile tinnitus. He cut off the blood flow to my brain though strangulation which caused the noise to stop completely (It was bliss after six months of non-stop whooshing!). He could also hear the pulsing sound by placing a stethoscope on my temple. Other than the whooshing, I've had headaches, dizziness, and difficulty with words (Increasingly saying wrong words when I'm speaking with someone, either a completely unrelated word popping up in a sentence or stumbling/stuttering). He was concerned and immediately scheduled an arteriogram.

When I arrived at the hospital, they decided the arteriogram was too extreme at this point, so they chose to do a MRI/MRA scans instead. The results showed clear arteries with no signs of an AVM. However, they did find some type of mass on my left frontal lobe and a possible mass in the parietal region. I went to see a neurosurgeon at this point. He disagreed with the surgeon at the hospital (who was supposed to do the arteriogram and instead reviewed my MRI/MRA scans) and also with the ear specialists (Their theory was a slow growing tumor or a blood filled one). The neurosurgeon felt that I just had enlarged blood vessels or arteries and that was it. He did say that the "slice" on the MRI/MRA scans showing the spots weren't very good. (The parietal and frontal lobe mass were visible on this particular slice, if I remember correctly).

I returned to the ear specialist since the sound was and has been getting louder and he once again cut off the blood flow in my neck briefly and listened to the pulsing sound. He was still concerned and sent me in for an arteriogram to test for an AVM. I was awake during the procedure and told that it looked okay, but they would need a few days to go over the results. This was last week and I'm currently awaiting the results. I believe the possibility of a tumor is still on the table with 3 of the four doctors I've seen either considering it or convinced that is the diagnosis.

In the past, the only major medical problems I've had are sleep maintanence insomnia and extreme difficulty falling asleep (About 3-4 hours without medication - can only maintain sleep for 2-3 hours at a time usually when I finally do fall asleep or worse - 15-30 minute bursts), which I've had for as long as I can remember. This might be nothing, but I also have an aversion to certain textures (Velvet, suede and similar fabrics give me extreme chills, goosebumps, and make me almost sick if I come in contact with them), sensitivity to temperature changes, and cold hands and feet.

My question is - is it possible this sudden whooshing noise is simply an anatomical issue and not a tumor? Could it just be enlarged veins or arteries? If so, why would I suddenly develop the ability to hear my heart beat and blood flow at the age of 24? Wouldn't it have been an issue earlier? Is the sound a sign of vascular disease? If the arteriogram is clear, is a tumor also ruled out, especially the blood filled type?

The sound is maddening and very loud, especially when my heart is working harder than normal (Sick or exercising). I've noticed some psychological and behavioral changes in the last eight months as well, but as a close-to-graduation psych major, I also know that the tinnitus might be causing those symptoms due to stress or anxiety. None of my doctors have asked me about it, even after the frontal lobe mass was spotted, so I'm not sure what, if any, psychological problems a tumor could cause.

Thank you so much for any help you can give me. I greatly appreciate it.
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3 Comments Post a Comment
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Avatar_n_tn
Leslie,

I just found your post and your symptoms are very similar to mine, when I read your post I just couldn't believe how similar.  Anyway, I do not see any replies, I can not believe no one has any comments.
I did have an MRI and an AVM was identified.  The MRI report suggested CT Scan of Temporal Bones, after having that done and reading more on the internet, I now wonder if the CT Scan should have been of the Temporal Lobes, not Temporal Bones.  My hearing loss is in the right ear and the AVM is in the Left Frontal Lobe.  My ENT's nurse called yesterday to advise the CT Scan results did not find anything and the doctor recommends his original recommendation, replacing the Stapes (I cancelled this surgery before, because "my gut" felt like it was something else because in Sept '07 he did surgery and said the 3 bones had lots of scare tissue, which he removed and said after doing so, all 3 bones were moving properly, and my ear drum was really thin, so he made it thicker.  But since then, my hearing has NOT improved at ALL.  So my thinking was if the Stapes was moving/working properly then, wouldn't my hearing improve at least somewhat, but since it didn't, I could not understand how replacing the Stapes would be the answer.  So they ordered the MRI and then the CT Scan), so the surgery is scheduled for Jan 21st, but again "my gut" does not feel right, so I am back on the Internet looking for answers.
Sorry for the long Comment.......

Where do you currently stand?

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Avatar_f_tn
Hi,

While I would not wish these symptoms on anyone, it is nice to know that I am not the only one experiencing them. An AVM was ruled out along with the neurosurgeon's theory of an anatomical abnormality. One doctor still feels that the area on my frontal lobe is a slow growing tumor, while another now thinks that I have a venous hum (Which is more of a heart/artery issue than brain). In that case, the blood is moving so fast through my brain that it is making everything vibrate. I'm lacking two of the major symptoms for this though (A sound similar to a heart murmur in my chest and a change in volume on the whooshing noise when I lay down or stand). So I continue to hunt the internet as well between appointments. I'm seeing my specialist again in two weeks and will probably request to see a cardiologist at that point if we decide to investigate the possibility of a venous hum. I don't want to take any chances on the diagnosis. I want them to be absolutely positive. It is incredibly frustrating though and the wait is difficult. I hope things work out for you and you get the answers you're seeking. Take care.

-Leslie
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Avatar_m_tn
I'm very intereted in what you have written as my symptoms started in Sept 2011 and I've had CT of temporal bones, seen an ENT, ultrasound of neck; and currently being referred by my doctor to a neurosurgeon to see what is happening and find out the cause.  I've been diagnosed with Pulsatile Tinnitus and wouldn't wish it on my worst enemy.  It is driving me crazy.   Doctor thought it was due to high blood pressure and the medication had caused it therefore changed meds and its still horrible.  My memory is terrible and I have difficulty with  words.  Unfortunately this is not my ownly medical problem.   I wish you well and hopefully there will be a result for all.  Thanks for posting your information.
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