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POV: You Hear This at Night. Sources- PMID 40693879 mrashleyhaynes on TT Pulsatile tinnitus is often distinguished from the more common "ringing" tinnitus because it is a mechanical sound: a rhythmic thumping or whooshing that perfectly syncs with the patient’s heartbeat. While standard tinnitus is often idiopathic or related to hearing loss, pulsatile tinnitus is frequently a "bruit," or the actual sound of blood flowing through nearby vessels that the ear is picking up. Because of this mechanical nature, medical literature suggests that an identifiable, often treatable, physical cause can be found in the vast majority of cases, up to 70%, if a thorough diagnostic "work-up" involving specialized imaging is performed. The causes are generally categorized into vascular, structural, or systemic issues. Vascular causes might include idiopathic intracranial hypertension (IIH), where increased pressure in the fluid around the brain compresses the veins, or narrowing of the blood vessels (stenosis). Structural causes can include a "dehiscent" or thinning bone between the ear and the large vessels of the neck, which essentially removes the soundproofing that normally keeps our internal plumbing quiet. Because these causes are physical, they often respond well to targeted interventions like stenting, surgery, or medication to lower internal pressure. This high rate of "curability" makes it essential for patients to seek a dedicated neuro-otologic evaluation rather than simply being told to "live with it." #tinnitus #hearing #health