Dural Arteriovenous Fistula Presenting with Pulsatile Tinnitus

Abstract

　Pulsatile tinnitus could have diverse etiologies; it is important to exclude organic diseases when evaluating this symptom. We report a case of transverse-sigmoid sinus dural arteriovenous fistula who presented with the chief complaint of pulsatile tinnitus. Confirmation of change in the severity of the tinnitus by compression of the neck blood vessels and auscultation are very important to diagnose pulsatile tinnitus. Magnetic resonance imaging (MRI), especially magnetic resonance angiography (MRA), is the diagnostic modality of choice. When looking for a cerebral or basilar artery aneurysm using maximum intensity projection (MIP) imaging, the dural vasculature may be overlooked; it is important to check the original MRA images for abnormalities in the dura and elsewhere. Dural arteriovenous fistula is a rare, potentially curable entity, and a possibility of this condition should be kept in mind in patients presenting with pulsatile tinnitus.