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This patient with pulsatile tinnitus had two possible lesions obstructing venous flow on the affected side. It persisted despite endovascular treatment of the lesions with embolization and stenting. It could not be stopped by neck compression, and she has somatic tinnitus which raised a suspicion that her pulsatile tinnitus could have a migraine cause. Trials of chronic migraine management revealed a response to CGRP medications used for migraine management.
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