Hey everyone! I just got my CTA today finally! I wanted to add some images for you guys to see! What do we think? I emailed all the images over to my surgeon (who needs images before I can get an appt). I’m so nervous just from being dismissed for so long by so many doctors that I’m never getting this surgery. 
trying to remain hopeful though because I’m a long way from where I was before I found this site! 
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Im not so good at looking at these but at first glance it appears that at least in 3D you can only see the head, not the full neck. On one side (R?) one styloid looks like it was cut off. They appear to be very thick. Was this ordered as a CTA of the head & neck? Its difficult to see if you have jugular compression without seeing the carotid or IJV. Sometime you have to play with contrast in radiant viewer to see at least the carotid. Im sure Isaiah will take a closer look at them for you.
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Hey thanks so much for replying! I have no idea what I’m doing with this program haha - these are def cut off but I’m going to try to play around alittle more and see what images I can get and I will add them. But yes, it was a CTA of head and neck.
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@Emmaann - The GREAT NEWS is it doesn’t look like you have IJV compression at least not in the axial image you posted. There appears to be lots of room between your styloids & the transverse processes of your C1 vertebra.
You did cut off the tips of your styloids in all the images so we can’t see how long they are, but even if it’s not much longer than what you posted, they’re thick & sort of curved which also contribute to the symptoms they cause. I’d say your imaging is just fine to diagnose you w/ ES.
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Oh and @Isaiah_40_31 thank you for the reply and for pointing everything out to me. Makes it a lot easier to understand. You’re the best!
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I’m not great with tech, so can’t label anything, but in the second lots of images you can see clearly the styloid is elongated…although there’s room between your styloid & C1 process, as can be seen on the image @Isaiah_40_31 labelled, it looks like there could possibly be some compression higher up, above the C1 and closer to the skull base? And it looks like there’s a small blood vessel crossing over the IJV at the C1 level which could potentially cause compression… Your neck is fairly straight too and seems to have lost it’s natural curve (known as military neck), which can sometimes make symptoms worse… there’s info about this & there are exercises you can do to improve the curve in here:
List of my favourite resources on YouTube to learn anatomy - General - Living with Eagle
If the doctor you send the scans to dismisses you - I’m sorry I can’t remember if you’ve said who that was? Then Dr Costantino would be a good bet in NY:
Dr Peter Costantino, 4 Westchester Park Dr, 4th floor, White Plains, (914) 517-8056
http://www.nyhni.org/find-a-physician/Peter-D-Costantino-MD,FACS
or Dr. James K. Liu, 200 S. Orange Ave, Ste. 265, Livingston NJ
Dr. James K. Liu | Top Neurosurgeon in Livingston, NJ
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Those do look thick at the skull base @Emmaann. In RadiAnt, you can take those side (sagittal) views and rotate them to look more from behind the skull. That angle can help show how close the styloid is to the IJV and nearby cranial nerve space right at the skull base.
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@Emmaann - You have among the most interesting looking vascular situations I’ve seen. Though both of your IJVs are unusual, if you aren’t having vascular symptoms, they’re most likely functioning just fine & should be left alone. “If it ain’t broke, don’t fix it.”
If you are having vascular symptoms (sorry I can’t remember your symptoms w/o searching for other posts), then you should by all means see one of the surgeons on our list who do vascular decompressions &/or a vascular surgeon. Your styloids are very long & “substantial” so at least having those cut back as close to your skull base as possible should help alleviate your nerve-based symptoms.
Your left IJV has a clear fenestration (where the vein branches then reconnects to itself). I think sometimes it’s the EJV that becomes one w/ the IJV, but I don’t know how to tell if that’s what’s happened in your case. You have a very small artery/vein that crosses your IJV up near C1 that could possibly cause some IJV compression in certain head positions.
The right IJV also appears to possibly have a fenestration which has a branch that has sent a tendril-like vein up to near C1 which could be causing compression in some head positions as @Jules noted. Your right IJV appears to have a more complex branching or fenestration situation (wish I knew more so I could give a better description) than the left one.
The greater horns of your hyoid are also quite thick but probably aren’t causing a problem.
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@Jules @Isaiah_40_31 @MGORNEAU thank you all so much for all the info! I’m sorry I’ve been having a few of what I call “I don’t have a brain” days and a lot of pain. I definitely have vascular symptoms unfortunately : wooshing in ears, dizziness, passing out, tunnel vision, extreme brain fog among so many others. I sent in my disc images to Dr. James Liu on Thursday evening. They will be calling me to hopefully schedule an appt soon and then hopefully surgery 
I’ll add more images and update more as I feel alittle better. I don’t have a computer that takes discs so as soon as I’m back over my moms I can try to get more images of the back of my neck.
Thank you all for so much support and info!! You’re all amazing
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Also I’m still waiting on my CTA report - very curious to see what it will say. Will post that also as soon as I get it.
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I’m glad that you’ve been able to send your images to Dr Lui, and hope that you hear from his office soon!
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Thank you @Jules ! Will keep you all posted.
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Thank you for this! I had no idea about military neck - thanks for the info and will look into it!
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Thank you so much for all the info! I don’t know what I would have done without this site!
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