Tinnitus Could Be Because of IH (Intracranial Hypertension)

[priya]

I am struggling with pulsatile tinnitus since a year now. It's in my left ear. Doctor has advised an MRA scan of my neck. He thinks it's because of intracranial hypertension. There is a fluid buildup. I had edema when I was pregnant last year. My gynecologist told me that tinnitus would go away as soon as I deliver. That did not happen, it's been 7 months now since I delivered my child and tinnitus is still there. I put on excessive weight during my pregnancy. So guys please watch out, if you feel you have gained weight (even a 5% excess weight commensurate to your regular weight) can give you tinnitus.

My symptoms:
1) pulsatile tinnitus in left ear. It goes away if I stick a finger under my left jaw bone.
2) excessive strain in eyes.
3) headache.
6) stiff neck and shoulders.
7) weight gain.
8) occurs mainly in females of child bearing age and who have gained weight.
9) flashes of light (photopsia).
10) double vision.
11) ghost image or blurry vision.
12) tinnitus worsens if stressed and tired or exhausted.
13) pulsing of the body in sync with the sound of tinnitus.

These symptoms match symptoms of a brain tumor, but it's NOT a brain tumor hence it's called pseudotumor cerebri. All this happens because of excessive fluid pressure build up in your skull. It's dangerous to live with intracranial hypertension for a long time because it can damage the eyes completely. The only way to get rid of this is to lose weight and maintain a healthy weight. Hope the info helps.

 

[Karl]

priya -
I think that you are hearing somatosounds - actual sounds - not tinnitus. No. 14, "pulsing" is typical of people with somatosounds. Some people call these "whoosers".

Last year, my wife was having health issues. She had lost a lot of blood from internal bleeding, and was hearing "whoosh-whoosh-whoosh" at night. After she was given blood (and surgery), the sounds went away.

True tinnitus is actually coming from the nerves in the auditory nervous system. It sounds like an "actual" sound, but it does not interact with other physical vibrations, like a heartbeat. If you can hear the sound in your head "beating" with other sounds, that's a characteristic of actual vibrational interference. Jastreboff says that tinnitus sounds do not exhibit "beats" with other sounds that we hear.

 

[Karen]

Hi, Priya, and welcome.

I've read up on IH a bit myself, since I've been searching for an explanation for my pulsating tinnitus. Karl is right; the symptoms you have described are a possible indication of pulsating tinnitus, which is different from ringing tinnitus. I happen to have both --- ringing and pulsating. Both of my don't come and go; they are with me all day and all night. I have a constant ringing/hissing sound, and a constant heartbeat sound.

Here is a link to the Intracranial Hypertension Foundation's website, explaining the symptoms, causes, and possible treatments for this condition:
http://www.ihrfoundation.org/intracranial/hypertension/info/C31

Priya, are you being treated by a doctor for this condition? I'm curious; did he/she suggest any sort of medication, or was the main suggestion about weight loss? Does the doctor feel that, if you lose some additional weight, the pulsating tinnitus will totally go away?

 

[priya]

Karl -
I hear heartbeat that is in sync with my own heartbeat. Doctor diagnosed it as Pulsatile Tinnitus. He used a stethoscope to hear the sound.

 

[priya]

Karen-
Yes i am undergoing a diagnosis by my ENT. He has prescribed an MRI or an MRA to rule out Aneurysm. He thinks its because of my sudden weight gain, excessive fluid in the body. He strongly believes that Pulsatile tinnitus always come with underlying causes and once you get rid of those causes PT 'd go away forever, thats good and makes me happy.
I have PT and i dont know how a regular tinnius feels like. But i always say to myself that nothing happens without a cause, even a regular tinnitus may have some cause not known yet.

 

[priya]

its been a while and i have noticed that my right ear has started making ringing sound. in other words its a subjective tinnitus. so now i am living with a PT in my left ear and a constant high pitched ringing in my right ear. its so annoying... no clue whats going on. I had my MRA in April and it was clear. it showed no abnormalities , i was checked for PT and nothing came out of it, yet the PT is still there..and ofcourse a new addition of subjective tinnitus in my right ear.

 

[Karen]

Hi, Priya,

I'm glad you got the MRA testing done; at least it rules out any abnormalities. Does the doctor plan to do any follow-up testing or medication?

I certainly understand what you're going through, as I'm going through the same thing. I don't have any abnormal weight gain, was tested (MRI and MRA, CT scan, carotid Doppler of carotid arties), and they could not find anything.

I still think the pulsating comes on suddenly, after some abrupt change to your vascular system. For me, it was from taking blood pressure medicine, and getting off it suddenly. Yours may have to do with pregnancy and weight gain, then loss.

From other people I've talked to with PT, I've learned that neurologists are good doctors to go to for this condition. ENT's often do not know much about PT, and are limited as to what they can offer. At least, that's been my experience. Please keep an extra copy of your MRA on hand, so that if you decide to go to a different doctor, you can have him take a look at your tests.

I wish you the best; let's both hope for some answers soon!

Karen

 

[priya]

Hi Karen

Thanks , that's a good point, thanks for bringing up the neurologist's opinion. it never occurred to me, at least. I have just got my MRA done and i am a bit apprehensive of CT scan because of its immense radiation exposure. I wish to know if you also hear a continuous high pitched head noise(cranial noise) and pulsing of that entire part of your body(as in my case i can feel the whole left part of my body pulsing when i am in a silent room).
I have also read articles where they often associate PT with hearing loss. but by God's grace there isn't any hearing loss for me..

As in your and my case one thing is common , blood pressure. i had high blood pressure in my 3rd trimester when it all started in me. and the day i delivered my baby my blood pressure issue was gone suddenly. may be it has something to do with the blood pressure or blood flow.

I am just hoping that it gets better or it stays the same and does not pose any serious risk 10-20 years down the line. Please let me know if you happen to go to a neurologist. i am gonna make an appointment soon and share results.

Priya

 

[Ricky81]

Hi. I have intracranial pressure as well after I was punched all over the head and ears.
I got a lumbar puncture done which brought down the pressure from 33.5 to 13. I think normal is 10-15.
Lumbar puncture helped relieve the pain in my head and I feel much better.
However it did NOT resolve my Tinnitus.

Here are my MRI results.
https://www.tinnitustalk.com/threads/could-intracranial-pressure-cause-tinnitus.6269/

 

[Frédéric]

A clinical and radiological study in patients with idiopathic intracranial hypertension

Tinnitus is mentioned in the full article : https://ejnpn.springeropen.com/articles/10.1186/s41983-020-00189-w

Abstract
Idiopathic intracranial hypertension (IIH) is one of the chronic causes of elevated intracranial pressure with no evident cause in neuroimaging and normal CSF analysis. It primarily affects overweight women of childbearing age.

Aim of work
To describe the clinical picture of IIH, neuroimaging and response to treatment after 3 months follow up in a sample of Egyptian patients.

Patients and methods
This was a prospective study carried out on 25 patients presented at Alexandria University Hospital with symptomatology of IIH. All the patients were subjected to complete history taking, neurological examination, fundus examination, lumbar puncture, and MRI brain and MR cerebral venography. The patients were followed-up for 3 months for assessment of treatment response.

Results
Patients' ages ranged from 1 0to 50 years, with a mean BMI 32.32 ± 5.28 kg m2. Headache was the presenting manifestation in 100% of the patients. About 60% of the sample were either misdiagnosed or had a delayed diagnosis. There was a significant positive correlation between CSF opening pressure (r = 0.504, p = 0.010), severity of headache (r = 0.472, p = 0.017) and grade of papilledema. Optic hydropes and empty sellaturcica were the most common MRI abnormalities occurring in 95.8% and 70.8%, respectively. Only 30% of the cases had normal MRV. Stenosis at genu junction and focal stenosis at transverse sinus occurred in 24% and 20% of the cases, respectively. Combined medical and serial lumbar puncture were the most effective line of therapy in the recruited patients.

Conclusion
Headache is the most common presentation of IIH, and its severity is positively correlated with papilledema grade. CSF pressure is also positively correlated with papilledema grade.

 

[Frédéric]

Another cause of Intracranial Hypertension and Tinnitus.

The Effect of Vertebral Venous Collaterals on Intracranial Hypertension and Related Symptoms in Patients with Bilateral Transverse Sinus Stenosis

Background: Vertebral venous collaterals (VVC) were often found in patients with bilateral transverse sinus stenosis (BTSS). The purpose of this study was to investigate the physiological role of VVC in BTSS patients.

Methods: The index of TSS was used in the assessment of BTSS severity. Subjects underwent a standard lumbar puncture to measure the intracranial pressure (ICP). Papilledema and tinnitus were evaluated by using Frisén's grade and questionnaires for tinnitus handicap inventory (THI), respectively. The intensity and impact of headache was assessed by using 10-point Numeric Pain Rating Scale (NPRS) and six-item Headache Impact Test (HIT-6).

Results: BTSS group had more patients with severe intracranial hypertension (IH) and less patients with normal ICP. BTSS patients had higher ICP than normal controls. Further analysis on VVC showed that VVC decreased the elevated ICP in BTSS patients and exerted no impact on ICP in normal controls. A similar incidence of VVC in BTSS patients and normal controls were found. BTSS patients with normal ICP and mild IH exhibited a higher incidence of VVC compared with those with severe IH. VVC, rather than the severity of BTSS, regulated the ICP. Furthermore, VVC alleviated IH-related clinical manifestations including papilledema and tinnitus in BTSS patients.

Conclusions: The present study demonstrated BTSS is correlated with IH. The presence of VVC, which is postulated to be congenitally formed, normalizes the elevated ICP and alleviated IH-related symptoms in BTSS patients. VVC may be used as an indicator of relatively low ICP in BTSS patients.