Levine S B, Snow J B
Laryngoscope. 1987 Apr;97(4):401-6. doi: 10.1288/00005537-198704000-00001.
Tinnitus is a frequent presenting symptom. Tinnitus that is rhythmic and synchronous with the patient's heartbeat is rare. Pulsatile tinnitus may be the only symptom of life-threatening and treatable diseases. The presence of hearing loss or vertigo focuses the diagnostic evaluation. The cause of pulsatile tinnitus may be found on otoscopic examination. Audiologic assessment and enhanced computed tomography often contribute to the diagnosis. Increased intracranial pressure should be excluded with a fundoscopic examination. Arteriography is required to diagnose life-threatening and treatable lesions in the presence of normal otoscopy, audiologic assessment, and enhanced computed tomography.
耳鸣是一种常见的症状。与患者心跳节律同步的节律性耳鸣较为罕见。搏动性耳鸣可能是危及生命且可治疗疾病的唯一症状。听力损失或眩晕的存在有助于聚焦诊断评估。搏动性耳鸣的病因可能可通过耳镜检查发现。听力评估和增强计算机断层扫描通常有助于诊断。应通过眼底镜检查排除颅内压升高的情况。在耳镜检查、听力评估和增强计算机断层扫描结果均正常的情况下，需要进行动脉造影以诊断危及生命且可治疗的病变。
