Clinical Reasoning: A 65-Year-Old Woman With New Headache, Pulsatile Tinnitus, and Visual Disturbances

A 65-year-old previously healthy woman noticed new-onset, gradual, blurry vision in her left eye with perceived loss of peripheral vision and pulsatile tinnitus in the left ear for the past 2 weeks. In the past year, she visited 3 different emergency departments for new nonpulsatile and nonthunderclap headaches, which she described as “searing” pain. The headaches were accompanied by nausea without phonophobia or photophobia, were not worsened …