Abstract
Pulsatile tinnitus is a unique auditory condition that may be associated with cerebrovascular or cranial structural abnormalities such as arteriovenous malformations (AVMs) and jugular bulb dehiscence (JBD). AVMs involve high-flow arteriovenous shunting, while JBD reflects a bony defect exposing the jugular bulb to the middle ear. Both conditions can cause vascular tinnitus, and their co-occurrence can pose clinical challenges. The authors present the case of an 84-year-old male with a 3-month history of left-sided pulsatile tinnitus relieved by manual compression of the ipsilateral internal jugular vein (IJV). CT Angiogram revealed a left parietal AVM and JBD, highlighting its crucial role in evaluating vascular tinnitus.