Causes of Pulsatile Tinniitus 

• Pulsatile tinnitus, also known as objective tinnitus, results from altered blood flow or increased blood turbulence near the ear.  People other than the person experiencing the tinnitus are often able to hear this rhythmic, pulse-patterned noise.  
• While there are several benign causes of pulsatile tiniitus such as strenuous exercise, atherosclerosis, and ruptured tympanic membranes, there are only a few serious etiologies.
• It is important that the astute emergency provider be aware of and know the appropriate treatment for the following life-threatening and/or high morbidity-associated causes of pulsatile tinnitus:

1. Idiopathic intracranial hypertension (previously known as pseudotumor cerebri)
2. Carotid artery aneurysm
3. Carotid artery dissection
4. Vasculitis such as giant cell arteritis