Question: After having remained seated for an hour or two typing at my computer, typing, I will sometimes experience a rhythmic whooshing sound in both ears upon standing up, and a sensation of my head being slightly fuller of blood than usual. The whooshing sound begins about thrity seconds to a minute after standing and builds up gradually over thirtry seconds to a minute or so and then lasts for about one or two minutes, at the very most. I sometimes feel slightly faint but have never lost my coordination, become confused or fallen over. I am in my early 50s and my blood pressure is within the 'normal'r range for my age. I do not have diabetes or any other serious diagnoses. This whooshing sound appears to happen more easily if I have been exercising an hour or two beforehand - for instance if I have been cycling, before sitting down to type.
This problem started about five years ago and is occurring perhaps less frequently than it was, because I have changed my posture while typing (sitting upright, rather than slouching, and in an ergonomic chair). I have made these postural changes at the advice of my physiotherapist, who has been trying to help me with the pain that I experience in the left rear quadrant of my neck, and which appears to be due to my spondylitis.

In the last couple of years I have spoken to two GPs about the 'whooshing sound' and they have given different diagnoses - first, basilar insufficiency syndrome, and, more recently, postural hypotension.

I would appreciate your thoughts on what the most likely diagnosis might be in this case, and on what I could do to (if anything) to ease the problem.

I am due to see a specialist for my neck problem, in three months time.

Thank you Dr Bhatti for your prompt response.

In answer to your query about my symptoms - the sound is identical in both ears: suggesting that there is a common cause of the tinnitus, I suppose.

Your reply suggest that the most likely diagnosis, based upon the information that I have given you, is some problem with the basilar arteries as a result of my cervical spondylosis. Could you clarify as to whether or not I am correct in making this inference, from your reply?

IF this does prove to be the correct diagnosis upon further investigation ( I have a hospital appointment with a orthoepedic upper spine specialist in two or three months time -then could you please answer the following questions:

1.) Can you give me an indication of what the prognosis would be?

2.) Is this condition likely to get worse as I age?

3.) Is it likely to become life threatening at any stage?

4.) Can it be controlled to any degree via medication or exercise regimes?

5.) Are there any surgical or other treatments for it (I would imagine that any surgical treatments would be quite risky).
It is probably also worthwhile my mentioning that my GP listened to the arteries in my neck with a stethoscope to check for turbulence as a consequence of atherosclerosis and could find no evidence of this. It was the apparently smooth blood flow in my neck that led him to diagnose postural hypotension.


Best Regards

XXXX

Dear Dr Bhatti,

Thank you for your helpful response.

You had mentioned that the condition is not life threatening. However, I wondered if it might increase the risk of my having a stroke or TIA as I get older? Of course I am not a doctor, but it would seem logical that if there are transient interruptions in the blood flow to my brain as a result of the arthritis in my neck and my posture at certain times, then this must surely raise the odds of a stroke occurring, especially as I get older, and my arteries narrow, as they do in the normal course of ageing.

I appreciate that this might be a difficult question for you to answer in the absence of the results of the investigations which I am due to undergo, but I wondered if you could give me some indication of whether or not my condition might increase my risk of stroke, and if so, at what stage in my life roughly (immediately, or in my late 50s or mid 60s for example) and whether or not it might therefore be worthwhile my being treated with blood thinning medication, at some stage in the future, so as to reduce the chances of a stroke occurring?

I am not strongly anxious about my condition at present, but your your answers will help me to frame the questions that I will ask, when I go to see the specialist orthopaedic practitioner, in July.


Best Regards

XXXX

Thank you Dr Bhatti,

Best Regards

XXXX