Pulsatile Tinnitus From Bovine Aortic Arch Variant
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Acta Otorrinolaringol Esp. 2012;63(4):324 www.elsevier.es/otorrino IMAGES IN OTORHINOLARYNGOLOGY Pulsatile Tinnitus From Bovine Aortic Arch Variant Acúfeno pulsátil por arco aórtico bovino María José Lesmas Navarro, ∗ Carlos De Paula Vernetta, Verónica Rodríguez Rivera Servicio de Otorrinolaringología, Hospital Universitario La Fe, Valencia, Spain When synchronous with arterial pulse, pulsatile tinnitus often has a vascular origin. It may be due to different causes, including vascular malformations, venous angiomas, vascu- lar tumours (glomus), increased intracranial pressure and blood flow alterations, among others. Magnetic resonance angiography is the test of choice for the diagnosis of most arterial alterations. We report the case of a 50-year-old woman who pre- sented pulsatile, chronic tinnitus in the right ear with over 25 years evolution, which increased with physical activity and decreased with cervical compression at the level of the carotid region. She did not suffer hearing loss, vestibular or neurological symptoms. Physical examination was unre- markable, with audiometry revealing a normal otoscopy and bilateral normoacusis. Magnetic resonance angiography (Fig. 1) showed a bovine aortic arch variant of the left common carotid which stemmed from a right arterial trunk and elongation of the basilar artery. The normal anatomical configuration of the aortic arch consists of 3 major vessels originating from this arch: innom- inate artery (brachiocephalic trunk), left common carotid artery and left subclavian artery. The so-called bovine aortic arch variant is a congenital anomaly of the aortic arch, whereby the brachiocephalic trunk and left common carotid artery arise from a com- mon trunk which stems from the aortic arch. It is the most Please cite this article as: Lesmas Navarro MJ, et al. Acúfeno pulsátil por arco aórtico bovino. Acta Otorrinolaringol Esp. 2012;63:324. ∗ Corresponding author. E-mail address: [email protected] (M.J. Lesmas Navarro). Figure 1 common congenital anomaly of the aortic arch (10%). This vascular malformation may be a rare cause of pulsatile tin- nitus. Its pathophysiological mechanism is possibly related to turbulences in arterial blood flow. 2173-5735/$ – see front matter © 2010 Elsevier España, S.L. All rights reserved.
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cta Otorrinolaringol Esp. 2012;63(4):324
www.elsevier.es/otorrino
MAGES IN OTORHINOLARYNGOLOGY
ulsatile Tinnitus From Bovine Aortic Arch Variant�
cúfeno pulsátil por arco aórtico bovino
aría José Lesmas Navarro,∗ Carlos De Paula Vernetta, Verónica Rodríguez Rivera
ervicio de Otorrinolaringología, Hospital Universitario La Fe, Valencia, Spain
hen synchronous with arterial pulse, pulsatile tinnitusften has a vascular origin. It may be due to different causes,ncluding vascular malformations, venous angiomas, vascu-ar tumours (glomus), increased intracranial pressure andlood flow alterations, among others. Magnetic resonancengiography is the test of choice for the diagnosis of mostrterial alterations.
We report the case of a 50-year-old woman who pre-ented pulsatile, chronic tinnitus in the right ear with over5 years evolution, which increased with physical activitynd decreased with cervical compression at the level of thearotid region. She did not suffer hearing loss, vestibularr neurological symptoms. Physical examination was unre-arkable, with audiometry revealing a normal otoscopy andilateral normoacusis.
Magnetic resonance angiography (Fig. 1) showed a bovineortic arch variant of the left common carotid whichtemmed from a right arterial trunk and elongation of theasilar artery.
The normal anatomical configuration of the aortic archonsists of 3 major vessels originating from this arch: innom-nate artery (brachiocephalic trunk), left common carotidrtery and left subclavian artery.
The so-called bovine aortic arch variant is a congenitalnomaly of the aortic arch, whereby the brachiocephalicrunk and left common carotid artery arise from a com-on trunk which stems from the aortic arch. It is the most
� Please cite this article as: Lesmas Navarro MJ, et al. Acúfeno pulsáti∗ Corresponding author.
E-mail address: [email protected] (M.J. Lesmas Navarro).
cvnt
173-5735/$ – see front matter © 2010 Elsevier España, S.L. All rights re
Figure 1
l por arco aórtico bovino. Acta Otorrinolaringol Esp. 2012;63:324.
ommon congenital anomaly of the aortic arch (10%). Thisascular malformation may be a rare cause of pulsatile tin-itus. Its pathophysiological mechanism is possibly relatedo turbulences in arterial blood flow.
served.
![Annals of Clinical Case Reports Case Report · artery. When characterized by pulsatile tinnitus, may indicate a neurological pathology [6]. Because of the pulsatile nature of tinnitus,](https://static.fdocuments.in/doc/165x107/5fc6c321266a1328af21a56b/annals-of-clinical-case-reports-case-artery-when-characterized-by-pulsatile-tinnitus.jpg)
