Dilated Collaterals Cause Progressive Weakness on All Limbs as result of Bilateral Jugular Vein Occlusion - Interesting IJV Bypass Treatment

There are vascular extensions such as SlicerVMTK extensions that may be needed to be downloaded. You need to go to the extension section and import all vessel extensions. Vessel segmentations tutorial can be found here (Overview | 3D Slicer segmentation recipes).

Additional tutorial materials can be found here (Documentation/Nightly/Training - Slicer Wiki)

Here is the best quick tutorial I found in this site(Making Your Own 3D Images from CT Scan- 3D Slicer Tutorial) save you a lot of time. Just follow the steps.

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@Msdstc looking at your Styloids. They definitely appear long and makes me wonder if these are prior to the recent surgery. I have no doubt that they are severely compressing your jugular veins by just looking at the faint signal of them.

They definitely are… my question is, do I need work on c1 as well? I’ve had 2 surgeries and basically nothing to show for it, but I know Hackman can fully remove those styloids

Still can’t figure out the vascular extension I have the bone aspect figured perfect at this point

You might wanna play with the circled bar when rendering. You can make adjustments

image

This. Is from step 7 of Making Your Own 3D Images from CT Scan- 3D Slicer Tutorial

Hmm I have but I’m still not getting any clear vessels

Was the CT a contrast enhanced or regular CT? If it is regular CT I am afraid you won’t be able to see the vascular system very well as the signal will be weak and indifferentiable from normal tissues. Contrast enhanced should make the vascular system visible.

It’s contrast enhanced I’m wondering I’m using the wrong series of images or something. I also have my cerebral angiogram workup

It looks to me like Dr. Annino did remove your styloids up close to the skull base, and what’s left is a section of calcified stylohyoid ligament on each side. Note that what’s left seems to be “free floating” i.e. not attached at either end. Typically when we see that, it’s ligament calcification not styloid elongation. Some doctors remove the styloids but disregard ligament calcification farther down. It can be as problematic as the elongated styloids are, thus both styloids/calcified ligaments need to be removed for good symptoms recovery.

I can see what @KoolDude is referring to as well as the calcification that has been left appears to be right up against the tps of your C-1 vertebra.

Perhaps I’m wrong but that’s what my perception of your images is.

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Actually I was assuming those were glitches or something. Dr Annino only worked on one side the right one and you can’t actually see the difference he made.

Oops! My mistake. I remember you saying you had two different doctors operate to shorten the styloids. That doesn’t change my opinion of what I see on your scan though. Definitely looks to me like ligament calcification disassociated from the styloids.

Im noticing that now as well that’s interesting. I wonder how much of this has to do with dental work.

Could definitely be ligament calcification, or imaging artifact. But another option could be fractured styloids, especially if they’ve been operated on but not removed. They look pretty similar to this:

Only my right side has been worked out but the 2 sides are identical

It will be interesting to see what Dr. Hackman says. He should be able to clarify what’s going on.

I’m now scheduled for a video consult with Dr lo and constantino on the 14th of this month actually

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Are they on our list, @Msdstc? I gave it a quick read but didn’t see their names (didn’t check every state). If not, you’ll have to let us know how your consult goes. We’re always looking for doctors to add.

Will be interesting to see how that goes!

A few bits of anatomy:

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