Objective: To describe the clinical picture and treatment of dural arteriovenous fistulas (DAVFs) presenting as pulsatile subjective tinnitus.
Study Design: Review of prospectively collected data.
Setting: Academic referral center.
Patients: Fourteen patients with clinically and radiographically diagnosed DAVFs.
Interventions: Treated by endovascular route.
Main Outcome Measures: Treatments, clinical course, complications, and evolution were evaluated.
Results: All patients presented with sleep-disruptive pulsatile tinnitus. Other symptoms included severe headaches, papilledema, proptosis, blepharoptosis, visual disturbances, and hemiparesis. Cortical venous drainage was present in 4 cases. Endovascular treatment was performed at least once by the arterial route in 14 patients and the venous route in 4 patients. The origin of tinnitus was always a vessel in or above the petrous bone. When these arteries or veins could not be visualized in the final control, the tinnitus disappeared. In the patients whose tinnitus returned, a vessel in the petrous bone could always be seen. There was no mortality.
Conclusion: Endovascular treatment is an effective and safe treatment of DAVFs presenting as tinnitus.
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