Hi & welcome!
Firstly, we’ve had quite a few members who have tried the PICL/PRP treatments, but they rarely help, when the styloids are causing vascular compression or irritating nerves, then the only real cure is to have the styloids removed. Looking at your CT you may need a C1 shave as well to relieve the compression on the C1 process. Doctors don’t agree on whether shaving the C1 can worsen instability, and also some doctors believe that removing the styloids can as well, but the doctors very experienced with VES disagree. Members have mixed opinions too…
You might find a couple of videos which members have posted here helpful by Dr Costantino & Dr Aghayev:
Dr Costantino IJV compression and surgery - Symptoms and Treatments / Doctor Information - Living with Eagle
A Review Of IJV Compression by Dr Aghayev - General / Research Papers - Living with Eagle
You could ask to be put on a cancellation list for Dr Hepworth, but I guess if you have to fly it probably won’t be easy to go at short notice… As well as Dr Hepworth and Dr Nakaji, the other experienced VES doctors we know of are Dr Costantino in NY, Dr Cognetti in PA, and Dr Lui in NJ. None nearer you obviously, but some might have shorter waiting times, I’m not sure.
Obviously we can’t say for sure whether the IJV compression is the cause of your symptoms, but other members have experienced these.
It sounds like the testing you’ve had done so far could well be enough for Dr Hepworth, Dr Nakaji does like people to have a CT venogram with pressure testing manometry as well. Not many places do this so you might not get that done locally if this is what you want to have done, there are risks though, so I wouldn’t rush into it…
There’s more detailed info about treatments which can help- there are some medications like anti-coagulants which can make the head pressure symptoms easier, sleeping propped up can help, icing as well. Here’s a link:
ES Information- Treatment: Pain Relief, Medications and Alternative Therapies - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
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