FINDINGS:
Duplex Doppler color flow sonography, 2D ultrasound of vascular anatomy, and Doppler spectral analysis of the bilateral internal jugular veins.
Right:
The internal jugular vein is widely patent with normal phasicity of flow.
Proximal jugular vein: Measures 1.6 x 0.9 cm with a velocity of 154.1 cm/s.
Jugular vein at the level of the SCM: Measures 1 x 0.4 cm with a velocity of 220.2 cm/s.
Jugular vein at the level of the carotid bulb: Measures 1.2 x 0.7 cm with a velocity of 62.9 cm/s.
Jugular vein at the C1 level: Measures 1 x 0.9 cm with a velocity of 47.6 cm/s.
Jugular vein at the level of the foramen: Measures 1.1 x 0.9 cm with a velocity of 98 cm/s.
Left:
The internal jugular vein is widely patent with normal phasicity of flow.
Proximal jugular vein: Measures 1.2 x 1.1 cm with a velocity of 164.9 cm/s.
Jugular vein at the level of the SCM: Measures 0.8 x 0.7 cm with a velocity of 153 cm/s.
Jugular vein at the level of the carotid bulb: Measures 1.3 x 0.7 cm with a velocity of 46 cm/s.
Jugular vein at the C1 level: Measures 0.8 x 0.9 cm with a velocity of 45.3 cm/s.
Jugular vein at the level of the foramen: Measures 0.7 x 0.8 cm with a velocity of 70.3 cm/s.
IMPRESSION:
Widely patent bilateral internal jugular veins with venous diameter and velocity as above.
Does this mean my styloids are not compressing my IJV’s? I was told by a doctor a little while ago they were compressed.
For whatever reason, most doctors have their patients’ IJVs tested w/ their heads in a neutral position when in reality they need to be tested w/ their heads in the positions that cause vascular symptoms. We have found that even when a patient requests that the test be done in the “provocative position”, doctors will not request that from the lab doing the testing.
Almost always, a neutral head position doesn’t show vascular compression because the styloids, unless very curved, are also in their most neutral position. Since they move as your move your head (since they’re attached to your skull base), they most often only cause compression when your head is turned left/right, looking up/down or diagonally left or right/up or down.
So the answer to your question is, no, it doesn’t prove your styloids aren’t compressing your IJVs. It only shows they aren’t doing so when your head is in neutral (i.e. lying on your back & looking at the ceiling).
I am not a doctor and do not know 100 percent for sure how to read this report. But velocities over 50 are a concern according to my doctor. 150 or even 70 is way too high. My report did say “there is evidence of compression at the….” But that may just be how the provider wrote it. My velocities were 150 on each side and I had styloid and jugular decompression surgery two weeks ago and already feel better. Surgery found my right jugular was occluded — the catheter for the venogram couldn’t even go through.
Edited: sorry @hyperichard I realize now you see Dr H too. These velocities are similar to mine and he said they are too high.
Also want to add. Ultrasounds are not a perfect test and are reliant on the person doing the ultrasound, how hard they press, like @Isaiah_40_31 said the position of your head etc. If The np at Dr H’s office says your scans show compression do not put a lot of weight in this test. I had a completely supposedly “normal” angiogram/venogram a year ago and it didn’t mean much except ruled out some things.
I did have bilateral compression of the jugular veins, but never had the pressure testing done, it was clear on my CT, so I’m not sure about the report…but what I’d want to ask about is why the right side jugular vein at the level of the SCM is so much smaller in diameter, & the pressure so much higher there? It is in the region of where the styloids, but we have had members who have had issues with the SCM compressing the vein & other structures.