I'm not very great at dealing with doctors. At my last appointment I mentioned my nonstop pulsing tinnitus for the second time. My otoneurologist said that he might want me to have an MRA. I have already had two MRIs that show nothing, and I'm concerned that this pulsing is vein related because every time I have vertigo it feels like something is dripping down the inside of my head. And the pulsing started after a plane trip where it felt like my neck was going to blow up after I got off the plane. Well, my doc's office called and said that before the next appointment I should have a brain MRI. I asked the receptionist if she was sure that the doc said MRI and not MRA, and she said yes, he told her he won't find anything on an MRA. I'm just not too sure that I need another brain MRI. What is he looking for that he hasn't already seen twice? Do I press this with him? I have to pay out of pocket for these tests.
Does your pulsing tinnitus match your heart beat? I notice that mine started right after I had shunt surgery on my bad ear. I wasn't sure what it was at first but then I timed my pulse by putting my thumb on my wrist and sure enough the puling tinnitus matched my heatr beat. Only thing I can think of is that a vein was pushed up next to my cochlea or something. I personally would get a second opinion before dishing out more money for a MRI.
I have severe pulsating tinnitus all the time and it is often accompanied by, what I term, loud explosions inside my head. These can be quite stressful as the explosions also send a sort of shuddering vibration through my body. They happen more so at night but not only. The pulsating is in time with my heartbeat and is damned annoying. Sorry can't advise about MRA or MRI but I would take whatever is going. It can't do any harm can it. If there is nothing found on MRI then you can ask for the MRA. Does that make sense?? Of course here in UK we don't pay for these tests so that makes a difference. Maybe you should get a second opinion. Good luck.