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Clinical Problem Solving: Radiology
March 15, 2010

Radiology Quiz Case 1: Diagnosis

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Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Otolaryngol Head Neck Surg. 2010;136(3):308. doi:10.1001/archoto.2010.10-b

Vascular tinnitus may originate from arterial sources, including neoplasms (glomus tumors), atherosclerotic disease, carotid-cavernous fistulas, dural arteriovenous malformations, an aberrant internal carotid artery, and arteriovenous malformations. Venous bruits may originate from stenosis or tortuosity of venous structures or may be a manifestation of intracranial hypertension (pseudotumor).1,2Our examination of choice for vascular tinnitus of presumed venous origin is computed tomographic angiography (CTA), as for other authors.13In the present case, an axial image demonstrated a right distal transverse sinus venous diverticulum extending through a dehiscent sigmoid plate into the mastoid complex (Figure 1). Wider windows for bone detail confirmed the osseous defect and the diverticulum (Figure 2, arrow).

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