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Clinical Problem Solving: Radiology
March 15, 2010

Radiology Quiz Case 1: Diagnosis

Author Affiliations
 

C. DOUGLASPHILLIPSMD

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.1-3In 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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