Evidence map›Paper›PMID 37311640›Full record

ArticleJournal of neurointerventional surgery2024

Clinical evaluation of pulsatile tinnitus: history and physical examination techniques to predict vascular etiology.

Daniel D Cummins, M Travis Caton, Kafi Hemphill, Allison Lamboy, Adelyn Tu-Chan, Karl Meisel, Kazim H Narsinh, Matthew R Amans

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurointerventional surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Review
  3. Balloon occlusion testing for non-sinus-stenosis venous pulsatile tinnitus: A technical case series.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Daniel D CumminsDepartments of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.ORCID http://orcid.org/0000-0003-2742-5669
M Travis CatonDepartment of Neurosurgery, Mount Sinai Health System, New York, New York, USA.ORCID http://orcid.org/0000-0003-1581-7702
Kafi HemphillDepartment of Neurology, University of California San Francisco, San Francisco, California, USA.
Allison LamboyDepartments of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
Adelyn Tu-ChanDepartment of Neurology, University of California San Francisco, San Francisco, California, USA.
Karl MeiselMcClaren Northern Michigan, Petoskey, Michigan, USA.
Kazim H NarsinhDepartment of Radiology and Biomedical Imaging, Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.ORCID http://orcid.org/0000-0002-2019-5461
Matthew R AmansDepartment of Radiology and Biomedical Imaging, Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA matthew.amans@ucsf.edu.ORCID http://orcid.org/0000-0002-8209-0534
University of California, San Francisco · USMcLaren Northern Michigan · USMount Sinai Health System · US

Funding

Improved durability of sinus stenting for idiopathic intracranial hypertension using advanced MR flow analysisR56HL149124 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI AMANS, MATTHEW · 2019 to 2019
$555k
NHLBI NIH HHS R56 HL149124
6 · The paper itself

Abstract

backgroundPulsatile tinnitus (PT) may be due to a spectrum of cerebrovascular etiologies, ranging from benign venous turbulence to life threatening dural arteriovenous fistulas. A focused clinical history and physical examination provide clues to the ultimate diagnosis; however, the predictive accuracy of these features in determining PT etiology remains uncertain.

methodsPatients with clinical PT evaluation and DSA were included. The final etiology of PT after DSA was categorized as shunting, venous, arterial, or non-vascular. Clinical variables were compared between etiologies using multivariate logistic regression, and performance at predicting PT etiology was determined by area under the receiver operating curve (AUROC).

results164 patients were included. On multivariate analysis, patient reported high pitch PT (relative risk (RR) 33.81; 95% CI 3.81 to 882.80) compared with exclusively low pitch PT and presence of a bruit on physical examination (9.95; 2.04 to 62.08; P=0.007) were associated with shunting PT. Hearing loss was associated with a lower risk of shunting PT (0.16; 0.03 to 0.79; P=0.029). Alleviation of PT with ipsilateral lateral neck pressure was associated with a higher risk of venous PT (5.24; 1.62 to 21.01; P=0.010). An AUROC of 0.882 was achieved for predicting the presence or absence of a shunt and 0.751 for venous PT.

conclusionIn patients with PT, clinical history and physical examination can achieve high performance at detecting a shunting lesion. Potentially treatable venous etiologies may also be suggested by relief with neck compression.

Indexed as

Physical ExaminationTinnitusAdultAgedAngiography, Digital SubtractionFemaleHumansMaleMedical History TakingMiddle AgedPredictive Value of TestsRetrospective StudiesAngiographyStrokeTechniqueVascular Malformation

Identifiers

PMID37311640
PMCPMC10716354
OpenAlexW4380488848

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.