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Post-traumatic pulsatile tinnitus: the hallmark of a direct carotico-cavernous fistula

  • B Lerut (a1), C De Vuyst (a2), J Ghekiere (a3), L Vanopdenbosch (a4) and R Kuhweide (a1)...

Abstract

Following trauma to her right frontal region, a 68-year-old woman suffered bilateral, benign, paroxysmal, positional vertigo and a left-sided, longitudinal petrosal bone fracture, with secondary facial palsy and ossicular luxation. From the onset, the patient complained of pulsatile, left-sided tinnitus. After eight weeks, she developed left-sided ocular symptoms, progressing from conjunctival hyperaemia and orbital oedema to an abducens nerve palsy, and ultimately to heart failure.

The case and the final diagnosis of carotico-cavernous fistula are discussed. Guidelines are proposed for a diagnostic approach to pulsatile tinnitus and for the optimal management of patients presenting with pulsatile tinnitus associated with ocular symptoms.

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Corresponding author

Address for correspondence: Dr Bob Lerut, Ruddershove 10, 8000 Brugge, Belgium. Fax: 003250452290 E-mail: boblerut@gmail.com

Footnotes

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Presented at the Royal Belgian Society of Otorhinolaryngology, Head & Neck Surgery, 20 May 2006, Leuven, Belgium.

Footnotes

References

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Keywords

Post-traumatic pulsatile tinnitus: the hallmark of a direct carotico-cavernous fistula

  • B Lerut (a1), C De Vuyst (a2), J Ghekiere (a3), L Vanopdenbosch (a4) and R Kuhweide (a1)...

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