I promised some images of my styloids and here are a couple. I don’t know how to upload traditional CT images or where to look for them. I only have Cone Beam CT images and some X-rays that I can upload. According to Dr. Jones in Charlotte, they are only 2.6cm and therefore not elongated. But as we know, they can still cause problems with the nerves and vascular structures in front of c1 and I believe that is what is happening with mine. One of the styloids looks kind of curved and pointed which can cause big problems. Most of my vascular symptoms are on head rotation which makes sense given the length and shape. Let me know what you think.
1 Like
@jrhode2873 see attached annotated images.
Your left styloid appears normal length, but the stylohyoid ligament has calcified segment.
Your right styloid looks a bit long. And I suspect your IJV on that side could be compressed between your styloid and C1, but won’t be able to tell unless you get a CT with contrast done.
You have full bilateral arcuate foramen. It’s seen as a normal variant where C1 calcifies over top of the vertebral arteries, but can sometimes cause stroke like symptoms.
Your hyoid looks like it’s pretty close to your spine. Would be good to get CT with contrast to see if the greater horns are digging into anything.
2 Likes
Thanks for this analysis, I really appreciate it. On that left styloid, is it safe to assume the calcified segment can cause the same symptoms as if the whole styloid was calcified?
I’ve done lots of research on the arcuate foramen. I don’t know of a surgeon in the country who does procedures on that. Also, there’s no evidence of a static compression in my angiogram even when I turn my head and some of my symptoms don’t line up with vertebral artery compression. If there was a specialist for that I would go see them. Just like Eagles, most doctors are quite unfamiliar with AF.
Here’s another image of the left side.
3 Likes
@jrhode2873 - I wondered if what I was seeing on your C1 (extra bony growths) was arcuate foramen but I’ve misdiagnosed it before so have stopped trying to “guess” at what I’m seeing. I need to do more research on it to understand better how it appears in imaging.
The section of calcified s-h ligament on the left side is plenty long & thick enough to cause symptoms. Whether or not it does simply relies on whether or not it’s touching any of the local nerves. Since you’re symptomatic on both sides, I shall assume it is irritating some nerves.
The right styloid looks like it’s actually sitting on the TP of C1 on the right side, but as I often say, this could be an “optical illusion” based on the angle of the imaging.
I’m sorry I don’t think we have the name of a surgeon who deals w/ Arcuate foramen problems, however, there has been a few discussions about it on our forum. You can find them by using the magnifying glass search tool & typing arcuate foramen into the search box.
I agree w/ @TML that you need a CT w/ contrast for us to best tell you what we see may be causing your symptoms.
2 Likes
I am doubtful that the arcuate foramen is causing any issues, but I just wanted to make sure you were aware it’s there. I have “partial” bilateral arcuate foramen where the loops are half calcified. Seems pretty common.
I think depending on the placement of the calcified stylohyoid ligament it could cause just as much grief as the styloid, but in other times not so much. When you tilt your head down, your right styloid is almost definitely squishing your right IJV, because the styloid is forced to move with the skull. But it’s possible that since your left calcified piece of the ligament has the ligament slack above and below it, it might not exert as much of a force on the IJV at the level of C1 as your right styloid. Does that make sense? In other words, if it came to surgery, I would probably prioritize the longer styloid on the right first.
1 Like
One of our members mentioned that after an unsuccessful ES surgery Arcuate Foramina (bridge) was suggested & noted on her CT; ‘Apparently I have an ossified ligament in my C1. As a result, a bony bridge was created “in theory” to protect my Vertebral Artery and SubOccipital Nerve from being compressed.’
But after consulting an expert doctor (who she didn’t name) at UCLA, his opinion was ‘He said it’s very common, sees it all the time, and non-life threatening!!! In fact he said neurologist don’t even order CT scans of the spine anymore because they find so much calcifications and typically they never cause a problem and when they do trust me your body sends off the alarm!!’
So hopefully that’s reassuring?
Here’s a link to the discussion:
2 Likes