Is pulsatile tinnitus also generated in the brain like normal tinnitus?
I have read some cases of pulsatile tinnitus can be cured with surgery, freeing the auditory nerve from the source of the pulsatile tinnitus.
Yes, because pulsatile tinnitus is caused by neurological damage, it has nothing to do with your ears or the auditory canal. It can be caused by a lot of different things which makes it hard to pin down. MCS - microvascular compression syndrome - (which they suspect I have) is when a vein shifts inside your brain - and it happens - and comes into contact with one of the auditory nerves - usually #8. So it picks up the blood pumping through said vein and presto that's pulsatile tinnitus. It can also be cause by a fistula - blood clot, a collapsed transverse sinus, white matter, broken veins and capilaries, trigeminal nerve damage, vascular loop compression - a vein that gets twisted. And there's still more but those are the main causes.
Most times these things resolves themselves in about 6-18 months. And other times it's as a simple as getting an alcohol injection to break up a blood clot, or complicated as major surgery to move the vein off the auditory nerve. So cross your fingers and hope it resolves itself.
The most important thing in the meantime is diet, exercise, and stress management. In short, eat right, exercise and mind the stress. Keeping your blood pressure and stress down makes a world of difference. If you drink and smoke, quit. Immediately. Cut out the junk food or keep it as minimal as possible. Try to eliminate sugar and salt as much as possible too. Never forget the body is ALWAYS trying to heal itself, so the more you help it along the better it can do that. Look at getting yourself on an anti-inflammation diet. Going for physio - osteopathy and acupuncture specifically - can help immensely too. Do yoga, soak in a hot tub, long hot showers, all help.
And yes, you can habituate to just about anything. The more you do the above mentioned stuff the better off you'll be. The first six weeks or so of my pulsatile tinnitus was so bad I was literally suicidal and didn't know if I'd make it. 4 months on and it's still irritating but I can deal with it just fine. For me I usually have 3 or 4 good days and then one where it's a but of a PITA. And that's usually because I slip up and eat some junk food or neglect exercise or I'm stressed about something else. When I'm on point with diet, exercise, and stress management a lot of the times it's so mild it's like it's not even there. It can and will get better but only if you put in the work. Good luck!