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Blood rush in ears, tension headache, hypertensive. Tinnitus or cervical spondylosis ?

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ENT Specialist
Practicing since : 1991
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Over the last couple of weeks I have started to hear blood rushing in my ears (both). It is worse in the evening (I'm either not having it during the day or not noticing). It usually comes with a minor tension headache which feels more like pressure than an aching or stabbing type headache pain. It may also be worth mentioning that I have been pre-hypertensive, or hypertensive depending upon which doctor I've seen over the last few years. Most recently my bp has been up at my doctors visits. The doc said that if it was up again they would start me on meds.
The rushing sound in my ears also comes with some discomfort. It is worst when I lay down and upon standing (if I've been sitting for a while). The sounds and sensations is pretty intense and I'm starting to get very worried over it. Any sugestions (other than follow up with my PCP, please) would be greatly appreciated. Thank you, much.
Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

My suggestions can be helpful if I understand your problem.

1. The sound can be 'Tinnitus' or a vascular bruit. Is it equally severe in both ears? If it is similar in both ears then you are looking at a common cause.
2. Pulsatile Tinnitus can develop due to many reasons. The simplest explanation in your case would be persistent middle ear inflammation or fluid accumulation. This can be picked up by basic ear examination and impedance audiometry.
3. Depending upon your age, blood pressure, noise exposure, history of recent head trauma, recent medicine intake and the result of the above tests, in the presence of headaches, it will be worthwhile to exclude ear wax buildup, hearing loss, anemia, hypertension, hyperthyroidism, increased blood lipids / cholesterol.
4. Get Cervical Spine X-rays done (to rule out cervical spondylosis), get a neck vessel color doppler (to rule out any plaques). These conditions will cause turbulent blood flow.
5. CT Temporal Bones / MRA (MR Angiography) to rule out any AVM (Arterio-venous Malformation), Glomus (rare vascular ear tumors).

Start from the basic tests first and let us know your results along the way. Accordingly I can suggest you few tips.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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