跟读练习: SVINutes: Pulsatile Tinnitus - 通过视频学习英语口语
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Hello, my name is Dr. Fazeev Siddiqui.
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I'm a clinical adjunct professor at the University of Michigan at Michigan State University.
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Today, I will guide you through the evaluation of pulsatile tinnitus, a condition that can reveal critical underlying vascular abnormalities.
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Pulsed-style tinnitus is a rhythmic sound often in sync with the heartbeat.
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Unlike common tinnitus, typically a ringing sound, pulsed-style tinnitus is often caused by vascular abnormalities that create vibrations transmitted to the ear.
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Pulse slide tinnitus can be heard as whooshing, thumping, or whooping noises.
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A thorough assessment is crucial.
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The first step, always take a comprehensive history.
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Ask about the timing and onset and if it's unilateral or bilateral.
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Next, move to the physical exam.
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Pay close attention to blood pressure as hypertension can contribute.
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Don't forget to auscultate the neck and skull for any bruise, indicating turbulent blood flow pointing to an underlying vascular issue.
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If the initial assessment is concerning, the next step is imaging.
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A brain MRI with MR angiography
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or a CT angiogram is typically the first line modality to evaluate for vascular abnormalities like arteriovenous malformation or dural fistula.
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A diagnostic cerebral endogram can be performed if there is a strong suspicion on screening non-invasive imaging.
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Common causes include arteriovenous malformation, dural arteriovenous fistula, and carotid artery stenosis.
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Other less common causes include venous sinus stenosis, sigmoid diverticulum, aberrant carotid artery, and cerebral aneurysm.
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Recognizing these early can prevent severe complications like a stroke or hemorrhage.
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A dual arterial systula is an abnormal connection between arteries and veins within the dual matter.
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This bypasses the normal capillary system, forcing high-pressure arterial blood directly into the venous system.
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The result is turbulent blood flow in the dual venous sinuses.
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This turbulence generates vibrations which can be transmitted through the surrounding tissue to the cochlea, causing pulsed tinnitus.
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If left untreated, dural arterioleus fistula can lead to complications like intracranial hemorrhage or venous congestion, making early diagnosis critical.
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Another common vascular cause of pulsed tinnitus is carotid artery stenosis, which occurs when and the carotid artery narrows due to plaque buildup or other factors.
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This narrowing creates turbulent blood flow as the high-pressure blood moves through the constricted segment.
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Carotid artery stenosis is a significant risk for ischemic stroke and, if identified early, can be managed safely with carotid enderectomy or stenting.
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Venous disorders are another important cause of pustile tinnitus.
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Common conditions include venous sinus stenosis, which narrows major venous pathways like the the transfer sinus or sigmoid sinus,
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leading to turbulent blood flow and elevated venous pressure.
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Other venous causes include jugular bulb abnormalities, such as high riding bulb or diverticulum, which may create vibrations that propagate to the inner ear.
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Recognizing venous causes early is crucial, as they may contribute to symptoms of intracanial hypertension or other complications requiring targeted treatment.
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Let's look at a quick case.
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A 78-year-old man with a remote history of pulsoil tinnitus presented with headaches.
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An MRI brain revealed a cerebellar hematoma.
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A diagnostic angiogram demonstrated a high-grade complex arteriovenous fistula with multiple arterial feeders.
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Multiple arterial embolization attempts could not completely resolve the fistula.
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Hence, a coil embolization of the non-functional left transfer sinus was performed.
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A complete cure was achieved after the venous sinus sacrifice the patient did well clinically the patient did well clinically.
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To sum up, pulse light tinnitus should always prompt a careful history, physical exam, and if needed, vascular imaging.
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Early identification of vascular causes is essential for preventing complications.
关于本课
您正在使用跟读技巧通过视频"SVINutes: Pulsatile Tinnitus"练习英语口语和发音。
每天练习15到30分钟，将显著提高您的英语流利度和发音准确度。
什么是跟读法？
跟读法 (Shadowing) 是一种有科学依据的语言学习技巧，最初开发用于专业口译员的培训，并由多语言者Alexander Arguelles博士普及。这个方法简单而强大：您在听英语母语原声的同时立即大声重复——就像是一个延迟1-2秒紧跟说话者的影子。与被动听力或语法练习不同，跟读法强迫您的大脑和口腔肌肉同时处理并模仿真实的讲话模式。研究表明它能显着提高发音准确性，语调，节奏，连读，听力理解和口语流利度——使其成为雅思口语备考和真实英语交流最有效的方法之一。