Assessment and management of pulsatile tinnitus

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's 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.