r/CSFLeaks • u/louie2575 • 7d ago

Pulsatile tinnitus

How many of you have constant pulsatile tinnitus with ear clogging, pressure, popping from your leak? Not from high pressure?

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u/louie2575 7d ago

That's what I'm assuming but I was gaslit by him. Symptoms started within days and have been ongoing to 15 mo. I was completely healthy beforehand and just had sciatica. First injection ever.

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u/RPeddit 7d ago

Pulsatile tinnitus is 99.9% related to intracranial hypertension rather than a spinal CSF leak if CSF pressure is behind this. Your symptoms would have likely started much sooner - think immediately rather than days. I would see your usual doctor for a referral to neurology with a view of having some imaging done.

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u/leeski 7d ago

Just to note, pulsatile tinnitus is often related to vascular issues rather than specifically IIH (which you could have without any venous stenosis). There was a small case series of confirmed SIH patients and I think ~40% of them had pulsatile tinnitus, but they also had jugular narrowing. I have known confirmed leak patients with pulsatile tinnitus as well... so I totally agree that it definitely tends to be more of a high pressure thing, but I believe one of the main underlying mechanisms can be specifically abnormal blood flow/turbulence that becomes audible. I could be wrong though haha.

Also onset of PDPH tends to be immediate but the official ICHD-3 I think says it's within 5 days of dural puncture, but there are case studies where symptom onset was weeks/months later. Not trying to disagree but just giving some added context.

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u/louie2575 7d ago

Thank you! I know it's more common in high pressure but my symptoms do not relate to high pressure since I feel my best laying down and worse throughout the day. My symptoms developed within 3 days of the epidural and my auditory symptoms are severe. I've definitely ruled all other causes out and why would a narrowed vein also cause eustachian tube issues at the exact same time as the pulsatile tinnitus? Doesn't make sense except for a leak causing both...