{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:08:55Z","timestamp":1784034535849,"version":"3.55.0"},"reference-count":32,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,11,14]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Pulsatile tinnitus refers to the perception of intermittent, often rhythmical sounds, which are typically throbbing, beating or whooshing in nature, and may or may not be synchronised to the patient\u2019s pulse. It may also be classified as either objective, where the clinician can also hear the sound on auscultation, or subjective, where only the patient hears it, often due to heightened awareness of blood flow in the ear. It is important for neurologists to have an understanding of pulsatile tinnitus as, especially when combined with other symptoms and signs, it may suggest a specific neurological or neurovascular diagnosis.<\/jats:p>","DOI":"10.1136\/pn-2025-004624","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T18:20:28Z","timestamp":1766600428000},"page":"306-312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment and management of pulsatile tinnitus"],"prefix":"10.1136","volume":"26","author":[{"given":"Yousef","family":"Hyder","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Birmingham, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Irving","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, University Hospital Birmingham, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satheesh","family":"Ramalingam","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital Birmingham, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1016-5207","authenticated-orcid":false,"given":"Benjamin R","family":"Wakerley","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Birmingham, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, UK"},{"name":"Metabolic Neurology, Department of Metabolism and Systems Science, College of Medical and Dental Sciences, The Medical School, The University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"2026071405250892000_26.4.306.1","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1001\/jamaneurol.2022.2189","article-title":"Global Prevalence and Incidence of Tinnitus: A Systematic Review and Meta-analysis","volume":"79","author":"Jarach","year":"2022","journal-title":"JAMA Neurol"},{"key":"2026071405250892000_26.4.306.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2016.05.009"},{"key":"2026071405250892000_26.4.306.3","first-page":"251","article-title":"Pulsatile tinnitus: a review","volume":"13","author":"S. D. Sharma","year":"2017","journal-title":"B-ENT"},{"key":"2026071405250892000_26.4.306.4","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30238"},{"key":"2026071405250892000_26.4.306.5","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2013.0451"},{"key":"2026071405250892000_26.4.306.6","doi-asserted-by":"crossref","DOI":"10.1007\/s40134-017-0199-7","article-title":"Pulsatile Tinnitus: Differential Diagnosis and Radiological Work-Up","volume":"5","author":"Pegge","year":"2017","journal-title":"Curr Radiol Rep"},{"key":"2026071405250892000_26.4.306.7","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1002\/lary.31838","article-title":"Improving Diagnostic Yield in Patients with Pulsatile Tinnitus: A Ten-Year Analysis","volume":"135","author":"Sismanis","year":"2025","journal-title":"Laryngoscope"},{"key":"2026071405250892000_26.4.306.8","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3283493fd8"},{"key":"2026071405250892000_26.4.306.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2004.02.025"},{"key":"2026071405250892000_26.4.306.10","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.anl.2016.12.004","article-title":"Pulsatile tinnitus and carotid artery dissection","volume":"45","author":"Shimizu","year":"2018","journal-title":"Auris Nasus Larynx"},{"key":"2026071405250892000_26.4.306.11","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-228865","article-title":"Aberrant internal carotid artery in the middle ear: the duplication variant","volume":"12","author":"Anagiotos","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2026071405250892000_26.4.306.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2013.01.018"},{"key":"2026071405250892000_26.4.306.13","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1097\/MAO.0000000000003213","article-title":"Sensorineural Hearing Loss and Tinnitus Characteristics in Patients With Idiopathic Intracranial Hypertension","volume":"42","author":"Shim","year":"2021","journal-title":"Otol Neurotol"},{"key":"2026071405250892000_26.4.306.14","first-page":"e56","article-title":"An update on idiopathic intracranial hypertension","volume":"7","author":"Thurtell","year":"2010","journal-title":"Rev Neurol Dis"},{"key":"2026071405250892000_26.4.306.15","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1017\/cjn.2021.174","article-title":"Objective Audible Bruit in Idiopathic Intracranial Hypertension Resolved After Stenting","volume":"49","author":"Monsour","year":"2022","journal-title":"Can J Neurol Sci"},{"key":"2026071405250892000_26.4.306.16","article-title":"Current Perspectives on Idiopathic Intracranial Hypertension without Papilloedema","volume":"11","author":"Mollan","year":"2021","journal-title":"Life (Basel)"},{"key":"2026071405250892000_26.4.306.17","doi-asserted-by":"crossref","first-page":"4104","DOI":"10.1177\/0300060519857846","article-title":"Patients with pulse-synchronous tinnitus should be suspected to have elevated cerebrospinal fluid pressure","volume":"47","author":"Guo","year":"2019","journal-title":"J Int Med Res"},{"key":"2026071405250892000_26.4.306.18","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.1.245"},{"key":"2026071405250892000_26.4.306.19","first-page":"241","article-title":"Pulsatile Tinnitus Associated with Congenital Central Nervous System Malformations","volume":"17","author":"Wiggs","year":"1996","journal-title":"Otol Neurotol"},{"key":"2026071405250892000_26.4.306.20","doi-asserted-by":"crossref","first-page":"100580","DOI":"10.1016\/j.xocr.2024.100580","article-title":"Caroticochlear dehiscence-induced Tullio phenomena cured by vestibular neurectomy","volume":"30","author":"Elderee","year":"2024","journal-title":"Otolaryngology Case Reports"},{"key":"2026071405250892000_26.4.306.21","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/MAO.0000000000000968","article-title":"Prevalence of Pulsatile Tinnitus Among Patients With Migraine","volume":"37","author":"Weinreich","year":"2016","journal-title":"Otol Neurotol"},{"key":"2026071405250892000_26.4.306.22","doi-asserted-by":"crossref","first-page":"3625","DOI":"10.1007\/s00405-020-06586-4","article-title":"Microvascular compression of the vestibulocochlear nerve","volume":"278","author":"Walijee","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2026071405250892000_26.4.306.23","doi-asserted-by":"crossref","unstructured":"Ellenstein A , Yusuf N , Hallett M . Middle ear myoclonus: two informative cases and a systematic discussion of myogenic tinnitus. Tremor Other Hyperkinet Mov (N Y) 2013;3. doi:10.7916\/D8RX9BS1","DOI":"10.5334\/tohm.159"},{"key":"2026071405250892000_26.4.306.24","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811434504"},{"key":"2026071405250892000_26.4.306.25","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5334\/tohm.188","article-title":"Palatal Tremor \u2013 Pathophysiology, Clinical Features, Investigations, Management and Future Challenges","volume":"10","author":"Bhattacharjee","year":"2020","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"2026071405250892000_26.4.306.26","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2022.862420","article-title":"Retroauricular\/Transcranial Color-Coded Doppler Ultrasound Approach in Junction With Ipsilateral Neck Compression on Real-Time Hydroacoustic Variation of Venous Pulsatile Tinnitus","volume":"16","author":"Gao","year":"2022","journal-title":"Front Hum Neurosci"},{"key":"2026071405250892000_26.4.306.27","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2023-020440"},{"key":"2026071405250892000_26.4.306.28","unstructured":"National Guideline C. NICE Evidence Reviews Collection . Evidence review for imaging to investigate the cause of pulsatile tinnitus: tinnitus: assessment and management: evidence review k. London Health and Care Excellence (NICE); 2020."},{"key":"2026071405250892000_26.4.306.29","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1007\/s00330-024-11316-z","article-title":"ESR Essentials: diagnostic strategies in tinnitus-practice recommendations by the European Society of Head and Neck Radiology","volume":"35","author":"Verbist","year":"2025","journal-title":"Eur Radiol"},{"key":"2026071405250892000_26.4.306.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2023.08.017"},{"key":"2026071405250892000_26.4.306.31","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.1007\/s00701-018-3587-8","article-title":"Pulsatile versus non-pulsatile tinnitus in idiopathic intracranial hypertension","volume":"160","author":"Funnell","year":"2018","journal-title":"Acta Neurochir (Wien)"},{"key":"2026071405250892000_26.4.306.32","doi-asserted-by":"crossref","first-page":"103228","DOI":"10.1016\/j.amjoto.2021.103228","article-title":"Middle ear myoclonus: Systematic review of results and complications for various treatment approaches","volume":"43","author":"Wong","year":"2022","journal-title":"Am J Otolaryngol"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2025-004624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:25:35Z","timestamp":1784031935000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2025-004624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/pn-2025-004624"],"URL":"https:\/\/doi.org\/10.1136\/pn-2025-004624","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]}}}