Understanding Pulsatile Tinnitus: Symptoms, Causes, and Treatment

Understanding Pulsatile Tinnitus: Symptoms, Causes, and Treatment

  • Oct 09, 2023

Imagine lying in bed at night, trying to fall asleep, only to be kept awake by a rhythmic whooshing or thumping sound in sync with your heartbeat. For those suffering from pulsatile tinnitus, this is a frustrating reality. Pulsatile tinnitus is a rare but serious condition that can have a significant impact on one’s quality of life. Understanding its symptoms, causes, and treatment options is essential in managing this condition and finding relief.


Pulsatile tinnitus is a unique form of tinnitus characterized by rhythmic noises that are in synchronization with the heartbeat. It often indicates an underlying vascular issue or abnormal blood flow near the ear. In this blog post, we will explore the various aspects of pulsatile tinnitus, including its definition, causes, diagnosis, treatment options, and preventive measures.


Key Takeaways

  • Pulsatile tinnitus is a rare variant of tinnitus that can indicate an underlying medical issue.
  • Diagnosis and treatment options vary depending on the cause, from medications to lifestyle changes to surgical interventions.
  • Proactive preventive measures such as maintaining cardiovascular health, reducing noise exposure and practicing relaxation techniques can help manage pulsatile tinnitus symptoms.


Defining Pulsatile Tinnitus

Understanding Pulsatile Tinnitus


Pulsatile tinnitus is a rare variant of the condition, affecting a subset of tinnitus patients, characterized by rhythmical noises that are in sync with the heartbeat. Unlike non-pulsatile tinnitus, which typically manifests as a constant ringing sound, pulsatile tinnitus is often indicative of an underlying issue with blood flow or a modification in the perception of that blood flow near the ear. This condition can have a negative impact on one’s ability to focus, sleep, and work, and may even lead to depression or anxiety.


In some cases, pulsatile tinnitus may indicate a more serious health issue, such as a stroke or potential blindness, caused by turbulent blood flow.


Grasping the disparities between subjective and objective pulsatile tinnitus, alongside the rhythmical noise attributes, equips patients and medical professionals with the means to accurately diagnose the condition and pinpoint suitable treatment options.


Subjective vs Objective Pulsatile Tinnitus

Subjective pulsatile tinnitus is a type of tinnitus that is only perceptible to the individual experiencing it, generated by internal factors such as alterations in the middle and inner ear. It is inaudible to others and can be caused by internal factors including alterations in the auditory system, modifications in the blood vessels, and modifications in the brain, which can affect the perception of blood flowing. Treatment options for subjective pulsatile tinnitus may include medications and lifestyle changes, sound therapy, and tinnitus retraining therapy.


On the other hand, objective pulsatile tinnitus can be attributed to external factors, such as vascular malformations, idiopathic intracranial hypertension, and sinus wall abnormalities, which are types of blood vessel disorders. Objective tinnitus can be heard by both the individual experiencing it and others. Treatment options for objective pulsatile tinnitus may include medications and lifestyle changes, surgical interventions, and sound therapy.


Rhythmical Noise Characteristics

The rhythmic noises of pulsatile tinnitus can manifest as thumping, whooshing, or humming sounds. In some cases, these noises may be caused by head and neck tumors affecting blood flow near the ear. The characteristics of rhythmical noise associated with pulsatile tinnitus include a rhythmic swooshing or whooshing sound inside the head that often keeps pace with the pulse. This pulsating sound is caused by the circulation of blood through the body, beating at the same rate as the heart.


Identifying the specific rhythmical noise characteristics can help healthcare professionals determine the most appropriate diagnostic tests and treatment options for patients suffering from pulsatile tinnitus.


Common Causes of Pulsatile Tinnitus

human heart, blood flow, oxygenated and deoxygenated


Pulsatile tinnitus can be attributed to a variety of sources, such as vascular malformations, idiopathic intracranial hypertension, and sinus wall abnormalities. Each of these causes has unique characteristics and requires a different approach to treatment for pulsatile tinnitus patients.


The subsequent sections will provide an in-depth examination of these common causes and their contributions to pulsatile tinnitus symptoms.


Vascular Malformations

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Vascular malformations, such as arteriovenous malformations or dural arteriovenous fistulas, can lead to abnormal blood flow and pulsatile tinnitus. Arteriovenous malformations are abnormal connections between arteries and veins, while dural arteriovenous fistulas are abnormal connections between the dura mater and veins. Both can lead to abnormal blood flow and pulsatile tinnitus.


In cases where pulsatile tinnitus is caused by vascular malformations, treatment options may include medications, lifestyle changes, and surgical interventions to correct the abnormal blood vessels. Consulting with a healthcare professional is key to receiving tailored treatment options according to the specific type of vascular malformation detected.


Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension is a medical condition characterized by:


  • Increased cerebrospinal fluid pressure
  • Pulsatile tinnitus
  • Headaches
  • Double vision


In some cases, pulsatile tinnitus may be caused by glomus tumors, which are benign, yet locally invasive tumors that originate from glomus cells and are most commonly found in the portion of the jugular vein located beneath the middle ear.


Treatment options for pulsatile tinnitus caused by idiopathic intracranial hypertension or glomus tumors may include medications and lifestyle changes, surgical interventions, and sound therapy. In some cases, treating an overactive thyroid gland may also help alleviate symptoms.


Sinus Wall Abnormalities

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Signia Pure Charge&Go 7 IX


Sinus wall abnormalities refer to alterations in the walls of the sigmoid sinus, which can impede blood flow and generate noise in the sigmoid sinus, leading to pulsatile tinnitus. Identifying and addressing sinus wall abnormalities is a crucial step in treating pulsatile tinnitus caused by this factor.


Treatment options may include medications, lifestyle modifications, and surgical interventions tailored to the specific type of sinus wall abnormality present.


Diagnosing Pulsatile Tinnitus

Accurate diagnosis of pulsatile tinnitus is crucial in determining the most effective treatment options. Imaging techniques such as magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) play a vital role in identifying potential underlying causes of pulsatile tinnitus.


Subsequent sections will delve into these imaging techniques, elaborating on their importance in diagnosing the condition.


Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is a non-invasive imaging technology that produces three-dimensional detailed anatomical images. MRI scans can be utilized to visualize soft tissues, blood vessels, and any abnormalities that may be associated with pulsatile tinnitus. By providing a comprehensive view of the head and neck region, MRI can help healthcare professionals identify potential causes of pulsatile tinnitus and tailor the most appropriate treatment options.


Sometimes, an MRI scan may expose structural abnormalities like head and neck tumors or vascular malformations that contribute to pulsatile tinnitus. In these situations, further tests or consultations with specialists may be necessary to determine the best course of action.


Magnetic Resonance Angiography (MRA)

Magnetic resonance angiography (MRA) is a specialized form of MRI that focuses on blood vessels, aiding in the detection of any vascular issues leading to pulsatile tinnitus. MRA utilizes a powerful magnetic field, radio waves, and a computer to assess the condition of blood vessels and identify any narrowing or obstructions.


By identifying vascular abnormalities, MRA can aid healthcare professionals in deciding the optimal treatment options for patients with pulsatile tinnitus.


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Treatment Options for Pulsatile Tinnitus

Treatment options for pulsatile tinnitus depend on the underlying cause and may include:


  • Medications
  • Lifestyle changes
  • Surgical interventions
  • Sound therapy


Once the problem has been identified, the treatment for pulsatile tinnitus is effective. The cure rates usually match the patient’s expectations.


Subsequent sections will delve into the variety of treatment options available for pulsatile tinnitus.


Lifestyle Changes

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Phonak Audeo Paradise P90


Lifestyle modifications can be effective in managing symptoms and treating underlying health conditions causing pulsatile tinnitus. These may include:


  • Stress-reduction techniques
  • Avoiding loud noises
  • Obtaining adequate rest
  • Maintaining a nutritious diet
  • Engaging in regular physical activity


These lifestyle modifications may aid in reducing symptoms.


Surgical Interventions

Surgical interventions may be necessary for cases involving vascular malformations, tumors, or other structural abnormalities. Procedures such as surgical reconstruction of the sigmoid sinus diverticulum, venous sinus stenosis surgery, and endovascular procedures are among the surgical interventions used to treat pulsatile tinnitus.


Consulting with a healthcare professional is vital to identify the most suitable surgical intervention, depending on the specific cause of pulsatile tinnitus.


Sound Therapy and Tinnitus Retraining Therapy

Sound therapy and tinnitus retraining therapy can aid patients in managing pulsatile tinnitus symptoms by utilizing external sounds to mask or lessen the perception of the tinnitus. Sound therapy is a form of therapeutic intervention that uses auditory and vibratory inputs to modify an individual’s physiological and/or psychological state. It may involve sound healing, music, and specialized instruments to enhance physical and emotional health and well-being.


Tinnitus retraining therapy, on the other hand, involves a combination of sound therapy and counseling to help patients habituate to their tinnitus and reduce the negative impact on their daily lives. By retraining the brain’s auditory pathways, patients can learn to manage their tinnitus more effectively.


Unmissable Signs That Tinnitus Is Going Away

Tinnitus, characterized by ringing, buzzing, or other sounds in the ears, can greatly affect one’s quality of life. With a wide range of potential causes and varying levels of severity, it’s important to understand the signs of improvement and how to effectively manage and prevent tinnitus.


This blog post will guide you through recognizing the signs that tinnitus is going away, differentiating temporary and permanent tinnitus, exploring treatment options and preventative measures, and knowing when to seek professional help.


Prevention and Self-Management Techniques

Prevention and self-management techniques play a significant role in mitigating the impact of pulsatile tinnitus on an individual’s quality of life. By maintaining cardiovascular health, reducing noise exposure, and practicing relaxation techniques, individuals can take control of their condition and improve their overall well-being.


Cardiovascular Health

Focusing on cardiovascular health through the following methods can help prevent or reduce pulsatile tinnitus symptoms:


  • Regular exercise: This can enhance cardiovascular health by augmenting the strength of the heart and enhancing blood circulation. It can also reduce stress and anxiety, which can contribute to pulsatile tinnitus.
  • Healthy diet: A balanced diet that is low in salt and saturated fats can help maintain cardiovascular health and reduce the risk of pulsatile tinnitus.
  • Blood pressure management: Keeping blood pressure within a healthy range can help prevent or reduce pulsatile tinnitus symptoms.


Diet also plays an important role in cardiovascular health. Consuming a balanced diet low in saturated fats and high in fruits and vegetables can help reduce the risk of cardiovascular disease.


Managing high blood pressure is another critical component of cardiovascular health, as elevated blood pressure can increase the risk of cardiovascular disease and worsen pulsatile tinnitus symptoms.


Noise Exposure Reduction

Reducing exposure to loud noises and using hearing protection can help prevent damage to the auditory system and the development of tinnitus. Wearing earplugs or other protective gear when in noisy areas, abstaining from loud music, and utilizing noise-canceling headphones are some techniques for reducing noise exposure.


The use of hearing protection is essential to avert harm to the auditory system and the development of tinnitus. Utilizing earplugs or other hearing protection devices can aid in decreasing the likelihood of hearing loss and other health issues caused by noise exposure. Scheduling a regular hearing test can also help in monitoring and maintaining your auditory health.


Relaxation Techniques

Relaxation techniques, such as deep breathing, meditation, and yoga, can help manage stress and anxiety associated with pulsatile tinnitus. By calming the mind and body, these techniques may reduce the symptoms of pulsatile tinnitus and improve overall well-being.


Identifying and consistently practicing an effective relaxation technique is key to experiencing its full benefits. Incorporating relaxation techniques into your daily routine can help you better manage the stress and anxiety associated with pulsatile tinnitus and enhance your quality of life.



Pulsatile tinnitus is a rare but impactful condition that can significantly affect one’s quality of life. Understanding its unique characteristics, causes, diagnosis, and treatment options is crucial in managing this condition and finding relief. By focusing on prevention and self-management techniques, such as maintaining cardiovascular health, reducing noise exposure, and practicing relaxation techniques, individuals can take control of their condition and improve their overall well-being.


Remember, you are not alone in your battle against pulsatile tinnitus. With the right knowledge, support, and treatment plan, you can overcome the challenges posed by this condition and regain control of your life. Don’t let the rhythmic beats of pulsatile tinnitus hold you back – take action today and find the relief you deserve. Get in touch with our hearing care professionals.


Frequently Asked Questions


What is the main cause of pulsatile tinnitus?

The main cause of pulsatile tinnitus is disorders or malformations in the blood vessels and arteries near the ears, such as aneurysms or arteriovenous malformations, which can lead to a change in the blood flow. Additionally, benign intracranial hypertension can also be the underlying cause.


How serious is pulsatile tinnitus?

Pulsatile tinnitus is a potentially serious condition, with underlying causes which can often be identified. It is important to seek medical advice if you experience pulsatile tinnitus, as it may require treatment or further investigation.


Why is pulsatile tinnitus a red flag?

Pulsatile tinnitus can be a symptom of a serious problem with the blood vessels in the head, potentially indicating progressive vascular abnormalities, sudden hearing loss, or even a stroke. Because of this, pulsatile tinnitus should be taken seriously and prompt a visit to a doctor for further evaluation.


When should I be concerned about pulsatile tinnitus?

If you suddenly experience pulsatile tinnitus, it is important to seek medical evaluation as soon as possible, as it could be a symptom of a more serious condition. Seeing a doctor right away is the best course of action to determine the cause and treatment options available.


I can hear my heartbeat in my ear?

If you hear a steady beat or whooshing sound in your ears that follows the rhythm of your heartbeat, you may be experiencing pulsatile tinnitus. It is usually characterized by hearing a constant sound that others do not hear, and its speed can be affected by changes in your heart rate. Pulsatile tinnitus can be caused by a variety of conditions, including high blood pressure, anemia, and certain types of tumors. It can also be caused by a buildup of fluid in the ear, or by a narrowing of the arteries