CT Scan Results - PDF File

General
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I must admit, I am feeling extremely deflated today. Attached is the 2 page report summarized by the Radiologist. No where in the report does he mention anything about ES potentially impinging on nerves or something to that effect.

In fact, he basically says that the Styhloid looks normal.

This is after my original physician measured my Styhloids at nearly 50 mm from a general CT Scan…grrrrr.

I am just stuck, stunned, and really depressed that he did not find anything. (I know that sounds ridiculous, but after this many year, you WANT them to find something…anything to point to what is causing your ailments. Ugh.

So…here is the report. Any input is appreciated.

I feel like just going home and chilling on the couch today and telling all the patients to call someone else…I have checked out.

Todd
528-CTFindings080813.pdf (154 KB)

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Todd,

Sorry you are feeling deflated. Do not put to much into the report. The reports will never mention nerve impingement. they just document their findings in general terms not to diagnose. If the tech is limited on ES knowledge then he is not going to even go there. The CT's are always taking with your head strapped down. So they can never see what happens if you look side to side or up or down. All my doctors concerning my images looked at the images for all my issues and most never even looked at the reports.

Do not give up!!! Keep pushing forward. Hope, faith and courage will get you to the right doctor who will help you.

Not to disrespect WA hospitals but I have not heard anything good so far form the members on this site that live in WA concerning ES. You may need to go to another state. I would recommend you contact & send all your images and reports to Dr. Samji. San Jose is not that far.

Or if you want to visit the AZ desert let me know there are options here. Dr. Nakaji/skull base neurosurgeon and Dr. Milligan/skull base ENT surgeon at Barrow's. I hope I have helped a little. If not check out for the day go home spend time on the sofa with a beer watching a funny movie.

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My CTA looks kind of normal, too, and the report didn't see anything with the arterial side of things. My other CT scan DID show compression, though.

Did you get a copy of the CD?

This scan sounds like it might be the kind that is done to show the images of the arteries, not so much the bony images? It would be like looking at the wiring of your house without the structure of the house showing up....just the wires. I don't know if they got detailed bony images on your scan, it's hard to tell by what was written, and because I don't know what is included in CTAs.

The rad writes about mild elongation (but no measurement- I realllllly wish there was a measurement here- and a slight curving inward of your styloid process) I know you got a 3D done, but I think that was of the arterial flow....not sure, again, if bony images were included in that. I wonder about the veinous flow, too. I wonder how much of that could be seen.

'without significant stenosis' in the extracranial arteries (I think that means just next to your skull, up where the styloid process would be affecting them). Does that mean there is some stenosis? Not sure. I wonder about that because my rad report of CTA says I have NO stenosis there. If you have some stenosis in this one position, maybe it's greater in other positions.

Like BigsBug said, this is in one position...laying down. I know that you had said that some of your symptoms were positional. You also have a contradicting report from the other doc about the length of the styloids...I'm really curious about that. I'd really try to pin someone down to a measurement from these images. I hope you can get someone to do that for you.

I had a pretty normal report on my CTA, too...similar to yours... Yet my doc found my other scans (CT and MRI) to be abnormal enough to discuss at a meeting of head and neck surgeons.

Sorry this report was not definitive for your condition... this time.

You're going to find something, it's just a matter of WHEN.

I wonder what part your neck plays in this. He used the word 'severe' when writing about the stenosis of the spinal canal. That caught my attention.

I like the idea of you seeing Dr Samji, too. What about taking these images to your first doc who wrote about the 50mm length?

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Thanks for the "pick me ups".

Today......deflated, but not defeated :o)

I have sent the CD (with all of the images) to my ordering physician at the University of Washington. If I do not hear / get an adequate synopsis of the image, I will take everyone's advice and send my burned copy of the image to Dr. Samji in San Jose for his review.

Forgive me as I am in the heart transplant business.......but how the fu## does one physician note a 50mm styloid with extreme width and curvature and the Radiologist notes "mild elongation with medial displacement of the styloid processes". Are they looking at the same damn patient or what....grrrr.

So.....I have multiple things that I am reviewing / evaluating at this point:

1) Let the physicians at The U of W in Seattle look at the images and make their own opinion. They may interpret it completely different?

2) Get a copy of my burned CD to Dr. Samji for his interpretation of the images.

3) Schedule an appointment with a Neuro Surgeon to evaluate the findings on my report re. Spondylosis of the cervical spine creates severe appearing canal stenosis at C5-C6.

I continue to take my migraine associated vertigo medications (Nortryptiline @ 150 mg and Topomax @ 100 mg) as that has been one of my diagnosis' as well.

Nothing seems to crack the egg though :o(

Will keep you all posted if anything material presents itself......otherwise, I will just keep plugging away. It has to be something......I was not made to be feeling this way for 6 years now, unless God has a sadistic sense of humor.

Todd

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Trying to think mechanically, here...I might be way off base, but.... I had this image of your C5-6 area pinching the spinal canal closed. It reminds me of an Arnold Chiari malformation. With a Chiari, part of the brain 'hangs' lower and sort of comes down out of the skull, effectively 'plugging off' the spinal canal down near the base of the skull. Your spinal fluid isn't being cut off at the base of the skull...it's just happening a little lower down (if this is happening like I am imagining).

Instead of your cerebellar tonsils 'pinching' off the flow, your C5-6 problem is doing this. Looking at Chiari symptoms, they pair up with a lot of yours. Maybe that's where your symptoms are coming from. I imagine that bending forward probably pinches that area off pretty good as well as anything that curves your neck forward or backward, or side to side.

Here are some symptoms of Arnold Chiari (I think you'd compare to a type I), just as a reference to what pinching off spinal fluid might do. Not saying that you have a Chiari, but that your neck issue might mimic the effects. Credit goes to Wikipedia and is copied from there:

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Tee said:

Trying to think mechanically, here...I might be way off base, but.... I had this image of your C5-6 area pinching the spinal canal closed. It reminds me of an Arnold Chiari malformation. With a Chiari, part of the brain 'hangs' lower and sort of comes down out of the skull, effectively 'plugging off' the spinal canal down near the base of the skull. Your spinal fluid isn't being cut off at the base of the skull...it's just happening a little lower down (if this is happening like I am imagining).

Instead of your cerebellar tonsils 'pinching' off the flow, your C5-6 problem is doing this. Looking at Chiari symptoms, they pair up with a lot of yours. Maybe that's where your symptoms are coming from. I imagine that bending forward probably pinches that area off pretty good as well as anything that curves your neck forward or backward, or side to side.

Here are some symptoms of Arnold Chiari (I think you'd compare to a type I), just as a reference to what pinching off spinal fluid might do. Not saying that you have a Chiari, but that your neck issue might mimic the effects. Credit goes to Wikipedia and is copied from there:

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Tee.....I like your thinking! You belong in the medical field or possibly an engineer. Aviation does not seem to fit. I will keep working on you until you become our next transplant surgeon :o)

I recognize that this was not the report that I wanted to see exactly.

However, I think there is enough "funky" (that is a medical term, look it up :) neurological deviations going on with me that something is going to match up here. Also, the original CT Scan showed a 50mm Styloid......which may be causing even more neurological issues in terms of impingement. I just do not know.

What I do know is that I have been sick for 6 years (holy fu##.....that is a long time)..........and I have come to a point where I am going to get this figured out, one way or another.

Flying to San Jose to go see the expert there is a non-issue. I have insurance through my hospital, I have a bazillion (again, a realistic number in the dictionary) hours of Sick Leave where I can leave for months on end, get paid and get this shit figured out!

I have been diagnosed with Migraine Associated Vertigo for about 3 years. In retrospect, I think the diagnosis, makes sense since a lot of these symptoms seem to cross over to one another. However, I have taken just about every migraine medication out there at every dosage and they have not made a dent........nothing.

That tells me that my issue is more anatomically related and may (or may not) require surgery to fix. I don't look like Igor......but I think my brain may resemble his!!!

I will follow up with the University of Washington to see what they make of the scan, the reading, etc. I will wait and see what their plan of care would be for me.

If it is not suffice, I will be high-tailing it to either San Jose or Arizona to get a better looksie at what Neuro issues are keeping me from playing shortstop for the Mariners and making millions. :o)

Will keep you all posted.

Thank you all for you input, care and compassion. I know everyone is going through their own internal battles.........I truly feel for all of you. Been there, still there.......no fun :o(

Peace out

Todd

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Todd,

Spring training starts in late February in AZ. I live in Scottsdale and perhaps we can swap houses for a week in March so you can tryout for the big leagues and I can get away from the desert :-).

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The M's suck already........the last thing they need is a 43 year old "has been" with dizzy issues.....ha!! Spring training sounds fun......it will be a "reward" for when I am feeling better. You will get to see the whole Seiger Clan!!! :o) (Don't worry.....we bring our wine and beer wherever we go !!!)

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That gives new meaning to the game, 'dizzy bat'!

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Yes, I have compromised hearing in one ear, but it is because of a botched stapendectomy. With Menieres, your hearing comes and goes sporadically.

Also, I do not have vertigo. Just a constant "fog" with ears ringing and generally unstable. Ugh

Todd