What mechanism of compression in Vascular TOS causes tinnitus and / or pulsating tinnitus? For me the "head noise" israel debilitating than the pain.

What type of tos did you have?

Neuro and venous TOS. Diagnosed 6 years ago with nTos but recently had a 3d MRI at UCLA but do not have final report. So my guess is venous TOS.

MRA showed compression of jugular vein by manubrium and high signal in sigmoid sinus. Also compression of BP in thoracic outlet and other vascular compression. I'm waiting for the radiologists report. It was done last week.

i am actually trying to drive this point across in another thread. VTOS and NTOS are two totally different disease processed. VTOS is by definition compression of the subclavian vein at costoclavicular space ( the space between your collar bone and your first rib ) NTOS is the compression of brachial plexus in scalene triangle (triangle consist of anterior scalene, middle scalene and first rib ) These are two separate spaces. In my experience ( close to 260 cases in the past two years). the best diagnostic test is a invasive procedure called venogram ( done by a catheter in the affected arm vein and contrast dye injected under x-ray ) this is the gold standard for VTOS dx. MRI or MRV or MRA is not the test of choice. the universal symptom of VTOS( aka effort thrombosis) is arm swelling.

Thank you for the clarification. I am just now trying to get a correct diagnosis. Originally this was WC and spent more time with attorneys and retirement boards reviews than physicians. Yes I know I have ntos and aware of the scalene triangle compression. Recently developed vascular symptoms. Have yet to see a vascular surgeon. I was side tracked with a MCA aneurysm clip and finding a cause of debilatating pulsatile tinnitus. Do not have Dural fistula ruled by Cerebral angiogram.
So in general can or is pulsatile tinnitus a symptom of arterial or venous TOS.

Short answer is no. Arterial TOS patient 99% time present with pulsatile mass in supraclavicular area related to the aneurysmal degeneration of subclavian artery. Aneurysms in this are can do two things 1. throw clots down to the finger tips. 2 thrombose and completely occlude and cause limb loss. 1% patient can present with vertebral artery stroke because vert. a comes off subclavian artery when subclavian artery thrombosis clots can got to brain. I have seen it once. Venous TOS in additional to arm swelling can cause pulmonary embolism ( i think of the hansons brothers (the band) had VTOS with PE) . should not give you pulsatile tinnitus.

I had this test preformed on me last week suggested from at least 4 twitter Interventional radiologists (yes I seem to have minimal support with my treating MD ) venogram ( done by a catheter in the affected arm vein and contrast dye injected under x-ray ) this is the gold standard for VTOS dx. ***Results ***they say the test was fine. Do you recommend the MRAMRVMRI?? I have all the warnings but I have intermittent swelling arm activity, as well as intermittent cessation of flow on artery and (veins arm up) You can view my photos on ** Thank you