@1speechpick - I am wondering what your symptoms are? I couldn’t find them mentioned. I had compressed jugular veins. I had 5 doctors before I was referred to my 6th one that figured out what I had. My diagnosis was confusing because my symptoms were intermittent at first - depending on my head position. I actually had initial symptoms of carotid artery compression but I think my styloid(s) shifted in position to where they were severely compressing on my jugular veins instead.
I hope you find a doctor that will listen to your symptoms and be able to do the proper diagnostic testing to confirm the diagnosis. Don’t give up! Keep searching. You are worth it. Not many doctors have ever heard of Eagle Syndrome and even less know of the vascular or carotid variants. Even people in the professions that you would think should know, don’t know the symptoms. My son is an Emergency Medicine doctor. When I told him of my diagnosis, he had to look it up. He said that there are over 1000 rare diseases, so it is impossible for doctors to know all of them. It is frustrating. I would imagine everyone on this site has had to battle up hill to get their diagnosis. You are doing a great job researching your condition. Keep going until you find the solution you deserve.
I am attaching a photo of my 3D CT scan with contrast. You can see the shading on the jugular veins. That is the compression. Once the doctor saw this, it confirmed her diagnosis.
Sounds like you had an amazing doctor!!! My symptoms are right sided pain in the throat, jaw line, cheek, and eye/temple. I also feel lke I have something in my throat. I also feel lightheaded and have horrendous headaches daily. My neurologist thinks it’s Eagles or glossopharyngeal neuralgia. I see en ENT tomorrow (3rd doctor’s appointment). I also have a possible issue with my left hyoid bone sitting too close to the carotid artery.
Thanks for our kind reply. Your styloids look long!!!
@1speechpick Yeah it is rare and I am not surprised he has not seen it before that does not mean, it does not exist as there are a number of documented cases where it has been causing Carotid compression/irritation/dissection and sometimes stroke. I have posted the internet image below on the thread I mentioned in my previous posts. These are Axial & Coronal images showing the Hyoid bone in between the bifurcation of the Carotid artery. The red arrow is pointing to the Hyoid Greater Cornu (horn). A & C are the axial images and B is coronal images in case you might want to check it in your head/neck CT. This is significant because the Hyoid Bone moves up/down with each swallowing (see the video below) also might slightly move when you turn your head along with Carotid artery which also moves with the neck a bit.
You can watch this video to see how the Hyoid bone moves with swallowing. Specially the last minutes of the youtube video with black and white imaging.
I finally figured out where the axial images are on the CT head/neck angio. Let me know what you think. I’m not sure what I’m looking at in these views. Thanks a million!!
@1speechpick Good you are doing a great job. I just wanted to point out that the level that these images were taken are below the Styloid level and above the Hyoid level so we won’t be able to see how either bones are interacting with the Carotid artery branches. So I have 2 examples below to show you how the axial slides look like at these levels. Try to play around more and see if you can identify them. I have labelled some of the major blood vessels in your CT Scan below for you to identify them. Once you are comfortable try to get several subsequent slides above & below at each level.
In this image, Blue arrow points to the Internal Jugular Vein (IJV), Cyan arrow points to the Internal Carotid Artery (ICA), Yellow arrow points to External Carotid Artery (ECA)and Red Arrow points to the Occipital Artery (reason why I show it here because it originates from the ECA but not to be confused with a compressing bone like the Hyoid horn). I show it in the 3D image below with dotted pink line where the this axial image might have been taken.
Here is the left side 3D Image you provided earlier and I am using it to show you where the I think the axial slide above might be taken at. The dotted pink line is where I think it is. Notice how close the occipital artery is to the External Carotid Artery and finally merging with it. The arrow colors match the slide above for consistence and are pointing to the same vessels as above. We will need to go bit below to see the left hyoid bone interact with the Carotid
This axial slide is lower than the one above but not quite the level of Hyoid and Carotid bifurcation. Again Blue arrow is pointing to IJV, Cyan arrow pointing to ICA and Yellow arrow pointing to ECA. Notice on the left side how far apart the ICA & ECA are and how close they are on the right side. This can also be seen on the 3D images you provided..
Example 1: Hyoid Level looks like this in Axial CT. The red arrow points the Hyoid Horn and the White arrow points to Internal Carotid artery. So see if you can go to this level.
Example 2: Styloid Level looks like this in Axial CT. The white arrow points to the Styloid and the white arrowhead points to Internal Carotid artery. So see if you can go to this level.
My surgeon said he removes the stylohyoid ligament (or what’s left of it after the elongated styloid is removed) so what remains won’t calcify & cause problems. He said the s-h ligament plays a very minor role in swallowing & we can live w/o it just like we can live w/o the appendix or tonsils.
