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Nomad's fix to edit G:\SteamApps\steamapps\common\Fallout New Vegas\Fallout_default.ini to change from bMultiThreadAudio=0 to bMultiThreadAudio=1 fixed the stuttering background music problem. If you have a high performance PC you can try changing the value to 8192 Wow, I should have Googled this earlier. I'll update if the music starts stuttering again. Save the file and launch the game again and it should stop the stuttering. Try opening the fallout.ini file in notepad and scroll down until you see iAudioCacheSize=2048 and change the value to 4096.
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Home Fallout New Vegas audio stutter Windows 10
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