Endovascular Interventions for Idiopathic Intracranial Hypertension and Venous Tinnitus: New Horizons Ferdinand K. Hui, MD a, *, Todd Abruzzo, MD b , Sameer A. Ansari, MD, PhD c,d,e BACKGROUND The term tinnitus describes a subjective ringing or buzzing in the ear, which may be continuous or pulsatile. Vascular causes of symptomatic, pulsa- tile tinnitus may include arterial variant anatomy (aberrant internal carotid artery, persistent stape- dial artery, neurovascular loop compression syn- dromes); high-flow arterial diseases, including hypervascular tumors (glomus jugulare or tympani- cum); arteriovenous shunt lesions (dural arteriove- nous fistula or arteriovenous malformations of the head and neck); and arterial diseases of the head and neck associated with turbulence or flow accel- eration (pseudoaneurysms and stenoses related to dissection, atherosclerotic vascular disease, or fi- bromuscular dysplasia). Venous causes of tinnitus are less well described and may result from congenital or acquired venous anomalies of the jugular bulb or sigmoid sinus (dehiscence, diver- ticula, aneurysms, fenestrations, webs) or steno- ses of the dural venous sinuses (transverse and/ or sigmoid sinus), including those associated with idiopathic intracranial hypertension (IIH). 1 The management of tinnitus remains complex, and a recent review of available randomized data regarding medical management of nonpulsatile tinnitus suggest that data is insufficient for best practice guidelines. 2 An older review by Dobie and colleagues 3 is similar in that the primary focus was nonpulsatile tinnitus, and that venous tinnitus was not described in terms of treatment protocols. Venous causes of tinnitus may also be sufficiently Disclosures: None. a Department of Radiology, Johns Hopkins University, Baltimore, MD 21287, USA; b Department of Neuro- surgery, Mayfield Clinic and Cincinnati Children’s Hospital, University of Cincinnati, Cincinnati, OH 45209, USA; c Department of Radiology, Northwestern University, IL 60611, USA; d Department of Neurology, Northwestern University, IL 60611, USA; e Department of Neurological Surgery, Northwestern University, IL 60611, USA * Corresponding author. E-mail address: fhui2@jhmi.edu KEYWORDS  Venous tinnitus  Intracranial hypertension  Endovascular intervention KEY POINTS  Pulsatile tinnitus from intracranial venous abnormalities is an uncommon and increasingly recog- nized cause of pulse synchronous tinnitus.  Venous Stenoses associated with idiopathic intracranial hypertension can be treated with venous sinus stenting though randomized data is lacking.  Venous abnormalities such as venous diverticulae or fenestrations may rarely cause venous tinnitus, and in select cases, may be successfully treated with venous embolization or stenting. Neuroimag Clin N Am - (2016) -–- http://dx.doi.org/10.1016/j.nic.2015.12.007 1052-5149/16/$ – see front matter Ó 2016 Elsevier Inc. All rights reserved. neuroimaging.theclinics.com