I recently had a CTA / CTV of the Head / Neck, but the doctor failed to have it evaluated for the styloid process. I made these 3D images from my imaging results and I hope to be able to ask my neurologist about them this week . I would like to understand what I’m looking at and if there is anything that should be addressed. Also, if I made the wrong images, I can redo them. I do not think that I have Long styloids, but they appear to be thick and possibly impinging blood flow. Thank you for any direction and opinions that are provided.
1 Like
There are some people in this group that can definitely do this way better than I, but I’m pretty sure I see significantly elongated styloids compressing the Jugular veins on both sides. The elongated styloids are the finger-looking bone-like things (pointing down and to the right in the first image and the opposite in the second, normally they are just a nub, not a finger) and the jugular veins are the tubes rising up from the bottom centers of the images. Compression happens when the tubes intersect the fingers, see how the tubes are getting smushed? Easier to see in the first image, but probably more severe in the second. If your neuro doesn’t see it, get a new neuro because if I can see it any doctor with any knowledge of this condition should be able to.
1 Like
It would be helpful to see the relationship of your C1 vertebra to your IJVs, @Dionisia7. It’s hard to see C1 with all the collateral veins you have behind your IJVs. Collateral veins develop to help the IJVs drain blood when the IJVs are not fully functioning. Collateral veins can cause skull base & occipital pain. The number & size of your collaterals seems to be an additional visual which can be diagnostic for bilateral IJV compression.
@RickAZ did a good job pointing out how your styloids are involved in the compression, but it’s also important to know if C1 is contributing to that.
I agree with @RickAZ & @Isaiah_40_31 about the IJV compression high up by the styloids… It’s also difficult to see your hyoid bone clearly as sometimes there can be elongated processes or calcified stylo-hyoid ligaments which can cause symptoms, in one of the images it looks as though the greater horns could be close to the carotid arteries but it’s not clear enough to say for sure.
What are your symptoms? Your thyroid cartilage look really calcified too, we’ve seen a few members with this recently although it doesn’t always cause symptoms- if this or the hyoid are an issue you tend to get throat pain, clicking, strangulated feeling, swallowing issues, although ES can also cause these so hard to tell! (I’m sorry, I’m no good at labelling images so can’t show you what I mean!)
Do you know if your Neuro is aware of ES? Many doctors are ignorant about it, so they might not be helpful, if this is the case you might have to try & get a consultation with one of the doctors on the list…let us know how you get on.
1 Like
@Jules, Thanks for pointing out the thyroid cartilage. I noticed it but didn’t mark it.
@Dionisia7 - Your thyroid cartilage is now annotated along with other structures I left out yesterday.
1 Like
Thank you for the assistance so far. I have added a few more images. These are from a regular CT scan that I had 7 months prior to the scans that you have looked at previously for me. Hopefully these will show the C1 process. I could not figure out how to remove the vessels from the CTA images. I really appreciate your time and information.
It doesn’t look like the C1 processes are causing a problem, so could well be more the angle & thickness of your styloids at the skull base?
I agree w/ @Jules. It seems your IJV compression is solely being caused by your styloids (except for the lower section of the left side which may be compressed by your carotid artery) which is good news as it’s potentially a less complicated surgery than having C1 shaved also.
1 Like