英文摘要 |
Pulsatile tinnitus is a rare but serious symptom usually with a specific identifiable cause. Patients with pulsatile tinnitus are likely to have a serious underlying disease such as internal carotid artery aneurysm, which has remained a therapeutic challenge due to the absence of evidenced-based treatment guidelines. The study reports a rare case of hypertension with bilateral cervical internal carotid artery aneurysm initially presented as pulsatile tinnitus in left ear. Detailed review of clinical history, physical examination and radiologic evaluation helped establish a correct diagnosis of internal carotid artery aneurysm in this case. The patient experienced symptomatic relief after his blood pressure was lowered to below 130/80 mmHg with the combination of three different classes of antihypertensive drugs and the use of aspirin for stroke prevention. He no longer experienced pulsatile tinnitus and no interval change of internal carotid artery aneurysm was observed during the next six-month follow-up period. As illustrated by the reported case, awareness of internal carotid artery aneurysm as a cause of pulsatile tinnitus is important; moreover, diagnosis should be performed by a multidisciplinary team with a structured diagnostic pathway. Treatment of internal carotid artery aneurysm involves several clinical disciplines and should be directed towards the correction of individual underlying risk factors such as hypertension. |