I have an intracranial dural arteriovenous fistula behind my ear for which I underwent stereotactic radio surgery 16 years ago. Results were favorable at the time. The unbearable pulsing noise subsided to a tolerable level. Recently the loud pulsating sound and squeaky straining sounds have returned, not the same as before but very uncomfortable, along with considerable tenderness behind my ear and at the base of the skull, the area within which the pulsations extend. Does anyone else suffer these symptoms? Does anyone know what conditions, medications, or changes cause the increased discomfort?