Boston-Based Doctor Specializing in Pulsatile Tinnitus?

[Jsakovits]

Starting in the fall I was under a lot of stress as a result of losing a good friend. I have had an MRI and a CT (angiogram?) and they have been reviewed by my local ENT and two otolaryngologists in Boston and they all said no vascular issues and indicated need to address anxiety around this.

Any suggestions on a Boston doctor specialized in pulsatile tinnitus or how to work through this?

Much appreciated!

 

[Stillsearching]

Been a few weeks since this post so hopefully you find this.

Dr. mohamad abdalkader out of BMC is absolutely brilliant. I had a cta done in January, have seen multiple doctors who couldn't say anything. Spent 5 minutes with Dr. Abdalkader and he found my issue instantly (oversized mastoid emissary vein. Benign and likely congenital). I have spent 15+ years searching for answers and he cracked the case in minutes. Was incredibly thorough, informative and helpful. I can't recommend him enough.

 

[Poppy Traxler]

I'll definitely keep Dr. Mohamad Abdalkader at BMC in my files. However, I'm in California. I've had multiple CTs, ultrasound(s), MRI, MRA and a cranial angiogram. What I have learned in my research/despair of this PT, is that my doctors here in California are so very ignorant, and have advised me only to stay in hypotherapy. I've been in hypnosis for a few months. Surprisingly it does help with PT. "There is nothing we can do." <-- that seems to be a blanket response from my doctors.
When I ask for a referral, what is apparent is how much I realize medical science hasn't figured out yet. I've received zero referrals.

 

[Stillsearching]

I'll definitely keep Dr. Mohamad Abdalkader at BMC in my files. However, I'm in California. I've had multiple CTs, ultrasound(s), MRI, MRA and a cranial angiogram. What I have learned in my research/despair of this PT, is that my doctors here in California are so very ignorant, and have advised me only to stay in hypotherapy. I've been in hypnosis for a few months. Surprisingly it does help with PT. "There is nothing we can do." <-- that seems to be a blanket response from my doctors.
When I ask for a referral, what is apparent is how much I realize medical science hasn't figured out yet. I've received zero referrals.

I went through the same thing Dr. Abdalkader found the issue instantly it was so surreal. I wonder if you could email him and find a way. What kind of doctors have you seen? Have you seen a neuro interventional radiologist?

 

[Wheella]

@Stillsearching Did your doctor propose a treatment plan? My neuro radiologist diagnosed that I have internal jugular vein stenosis, to be treated through medication.

 

[Stillsearching]

@Stillsearching Did your doctor propose a treatment plan? My neuro radiologist diagnosed that I have internal jugular vein stenosis, to be treated through medication.

Fortunately mine is benign. He can basically seal off the vein if the PT is bothering me, but otherwise no need. I'm just glad it's not something dangerous

 

[Wheella]

Hi @Stillsearching, how does one seal off the vein? Are we talking about an embolization or a coiling? Would this lead to other problems like higher intracranial pressure?

 

[tiniturtle]

Hi @Stillsearching, how does one seal off the vein? Are we talking about an embolization or a coiling? Would this lead to other problems like higher intracranial pressure?

The answer to this is not simple, but I'll try to make it so. The short answer is no, if you have normal vasculature, you can lose one of the large dural sinus veins without significant issues. I know this because it happened to me. Sometimes this is how DAVF are treated. Or, in my case, in the pathological course of the fistula, one of those veins will shut down, sometimes also taking down the fistula with it.

Usually to have higher intracranial pressure, there would need to be stenosis, or narrowing on both sides of the head. For me, the aforementioned vein did re-open after the fistula was treated, but it was significantly narrowed. The vein on the opposite side of my head was stented, so it would remain open as part of the treatment. A skilled surgeon will take all of these things into account.

 

[tiniturtle]

Fortunately mine is benign. He can basically seal off the vein if the PT is bothering me, but otherwise no need. I'm just glad it's not something dangerous

A more modern way to treat these now, is to stent the vein to open it more, as opposed to shutting it down. I have a stent in, and it's really not a big deal. I regularly forget it was ever done.

 

[Stillsearching]

A more modern way to treat these now, is to stent the vein to open it more, as opposed to shutting it down. I have a stent in, and it's really not a big deal. I regularly forget it was ever done.

You had a dilated emissary vein? I just got an update actually for a few more findings. High riding jugular bulb and prominent condylar vein.

 

[tiniturtle]

You had a dilated emissary vein? I just got an update actually for a few more findings. High riding jugular bulb and prominent condylar vein.

No, I had a dural arteriovenous fistula dumping into that vein, which damaged it. The vein shut down and later re-opened after it was treated.

 

[Wheella]

The answer to this is not simple, but I'll try to make it so. The short answer is no, if you have normal vasculature, you can lose one of the large dural sinus veins without significant issues. I know this because it happened to me. Sometimes this is how DAVF are treated. Or, in my case, in the pathological course of the fistula, one of those veins will shut down, sometimes also taking down the fistula with it.

Usually to have higher intracranial pressure, there would need to be stenosis, or narrowing on both sides of the head. For me, the aforementioned vein did re-open after the fistula was treated, but it was significantly narrowed. The vein on the opposite side of my head was stented, so it would remain open as part of the treatment. A skilled surgeon will take all of these things into account.

Thank you @tiniturtle. I didn't know you could sacrifice an entire vein, this is very new to me.

 

[Stillsearching]

No, I had a dural arteriovenous fistula dumping into that vein, which damaged it. The vein shut down and later re-opened after it was treated.

They want to run some more tests I may have that as well. I've asked before but what were your other symptoms? Any vertigo? Any ringing?

 

[David Dorci]

Been a few weeks since this post so hopefully you find this.

Dr. mohamad abdalkader out of BMC is absolutely brilliant. I had a cta done in January, have seen multiple doctors who couldn't say anything. Spent 5 minutes with Dr. Abdalkader and he found my issue instantly (oversized mastoid emissary vein. Benign and likely congenital). I have spent 15+ years searching for answers and he cracked the case in minutes. Was incredibly thorough, informative and helpful. I can't recommend him enough.

Can you tell me if you had a venogram from him? I am scheduled to have one although he seems to think he will not find anything. How was it? I am having it done because a doctor in NY said I may have transverse sinus issue.

Did your tinnitus sync with your pulse? Mine only does sometimes.

Thanks.

 

[scotty03874]

I'm in California.

Hamid Djalilian, MD | UCI Head & Neck

https://hamiddjalilianmd.com/