Sismanis A, Butts F M, Hughes G B
Department of Otolaryngology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298.
Laryngoscope. 1990 Jan;100(1):33-6. doi: 10.1288/00005537-199001000-00008.
Previously, the authors reported that objective pulsatile tinnitus can be the major or only manifestation of benign intracranial hypertension. This report updates the authors' experience with 31 patients managed over the past 7 years. Benign intracranial hypertension should be suspected in all patients with pulsatile-objective tinnitus, especially when the patient is a young, obese female with headaches and/or visual disturbances. Papilledema and small ventricles or an empty sella on computerized tomography are almost diagnostic. The diagnosis is confirmed by elevated spinal fluid pressure on lumbar puncture. In such patients, angiography is not indicated. Furosemide and acetazolamide are very effective. Ligation of the internal jugular vein is contraindicated.
此前，作者报道过客观性搏动性耳鸣可能是良性颅内高压的主要或唯一表现。本报告更新了作者在过去7年中对31例患者的治疗经验。所有患有搏动性客观性耳鸣的患者都应怀疑患有良性颅内高压，尤其是当患者为年轻肥胖女性且伴有头痛和/或视觉障碍时。计算机断层扫描显示的视乳头水肿、小脑室或空蝶鞍几乎可确诊。通过腰椎穿刺时脑脊液压力升高来确诊。在此类患者中，不建议进行血管造影。速尿和乙酰唑胺非常有效。禁忌结扎颈内静脉。
