Dr. Constantino and Dr. Hepworth - Differences

What is the main difference between these two doctors? Who is more experienced with Vascular ES? Does anyone know the long-term effects of their surgeries for Vascular ES? Are they both familiar with CSF and Intracranial Hypertension and Intracranial Hypotension?


The differences between Dr. H & Dr. C that I know of, are that Dr. H looks more at the whole body i.e. what’s going on besides just the ES symptoms. It used to be that in surgery, he would not do a C-1 shave but would cut the styloid back & move the IJV slightly away from C-1 to give it more room to expand. Recently there has been mention that he is either considering doing C-1 shaves or has begun doing them when necessary. Dr. H also requires the initial ofc visit to be in person with his NP who does the initial evaluation & decides if further testing is warranted. The second visit is scheduled a couple of days later with him. The gap day is for the purpose of getting the suggested testing done so Dr. H has the information he needs/wants when he sees the patient. I don’t know if Dr. H operates w/ another surgeon to assist.

Dr. C is pretty solidly focused on styloidectomies & vascular decompression which he is very good at. He has an assisting surgeon (usually a neurosurgeon, I believe) who does the C-1 shaving if it’s necessary. Sometimes that can’t be known until surgery is in progress. As you know, Dr. C is willing to do the initial consult either remotely or in person.


Very helpful! Thank you so much!

Have a nice night.

P.S. I did a Summary Letter to Dr. Constantino to save time in the Consult and for facts to not get mistranslated.


Writing is a summary is great. It will also help your conversation stay on target & not wander too much which happens easily when there is a lot one wants to discuss.

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Did you ever decide to see Dr. Hepworth?