Good afternoon everyone! I have a tough one for you. No one may have encountered this. On my CTA/CTV of head and neck, a right persistent fetal origin PCA was found. This has to do with the circulation in the brain and is called a “normal variant” that some people have (most don’t know they have it). It is not good in strokes, requires a varied approach in some surgeries of brain, and increases risk of aneurysm from what I have read. No aneurysm was noted on CT. I also have Eagle Syndrome, worse on right side. I am wondering, could vascular type of ES be misread as the PCA issue by a radiologist, since both affect the circulation to the brain (circle of Willis)? Also, will this alter my chances of being able to get the styloidectomy and ligament removal performed? (The way I understand it is that the carotid artery supplies the communicating artery which then supplies the PCA on the affected side. It can be bilateral. Most of my doctors have never heard of this either).
When I first saw the surgeon (who performs extensive skull base surgeries), I was new to ES and did not even know that many of my problems were caused by it. I did not even know what questions to ask or info to give him. After research, I am aware that most of my symptoms are likely caused by ES, and that I should have discussed the PCA issue with him. I am following up with his nurse practitioner until I decide to have surgery. I would like to go ahead with surgery, but do not know if I will see surgeon again until surgery day. I know I’m complicated and difficult. Just thought I would throw this into the mix. Does any of this make sense? Hope you all have a great day and are able to get the help you are searching for!
Based on the information you gave re: the PCA issue, I don’t think it should affect your ability to have vascular decompression since that is all done external to the skull & your PCA situation is intracranial.
I don’t know the answer to this, but the fact that your PCA doesn’t seem to be suffering stenosis or blockage of any sort, indicates to me (I’m not a doctor) that it probably won’t be significantly affected one way or another by a styloidectomy & vascular decompression.
It’s not anything I know about, but if you’re seeing his NP then obviously raise your concerns with them and ask that they speak to him about your case and the possible complications, and whether you could have a phone consultation with him before surgery to make sure you’re making an informed decision in case there are any more risks than with VES surgery? I know all the VES doctors are really busy, it’s hard to get appointments with them though!
@cooky I also have a fetal PCA. It’s much higher than the IJV on imaging and one wouldn’t be mistaken for the other. I had bilateral VES surgeries with no issues. It’s mainly an issue if we were to have a PCA stroke since most people can still circulate blood via the other side of the PCA and we don’t have one of those.
@cooky I also have a fetal PCA. It’s much higher than the IJV on imaging and one wouldn’t be mistaken for the other. I had bilateral VES surgeries with no issues. It’s mainly an issue if we were to have a PCA stroke since most people can still circulate blood via the other side of the PCA and we don’t have one of those.
Thank you. I just though some of the circulation issues noted with PCA might actually be due to ES compression of vessels causing flow issues. Just a wild thought.
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