Click the link to watch the video of my scan and tell me if you see anything on the right jugular and what might be compressing it
Thanks !
@Deanm -
In the top video, I only see C1 but I’m not good w/ the transverse CT images. In the second video I only see C1 & possibly another vascular tissue initially. It’s hard for me to tell for sure if your styloid is involved or not.
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At 9 seconds in on the second clip you can see a bit of compression between the styloid and C1 process, it’s hard to tell how much compression there is…
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I was told just now I have an enlarged Emissary vein on the right side that can be seen on the CT likely to help drainage of the jugular which adds to the case more significance
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@Deanm , are you able to upload just an image of your C1 area in the axial view? I’ve attached an image of mine to help you locate it. Can you upload an image/screenshot from the device rather than record from your phone? It’ll be a clearer image for us! I’ll be able to help interpret the axial view!
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@Deanm your C1 transverse process on your right side (left side of image) is pushed up against and is compressing your right IJV. Your right styloid seems to be not part of the compression though. At least it doesn’t seem so at this specific level of C1. Your left side seems good from this axial slice.
What are your symptoms? Might help me figure out if we should look elsewhere for any carotid compression!
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Head pressure , head ache , dizzy, brain fog , fatigue , heart racing occasionally, ear whooshing occasionally ,
Carotids seem fine on ultrasound when I did one
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Also bad neck pain sometimes and tightness and all symptoms worse when laying flat or turning head or standing up after sitting a while
I have some level of instability at c-1-2 as learned from a dmx as well
Main complaint by far is the head pressure / brain fog / dizzy “off” feeling
Comes and goes every day for 4 months
Not one day has gone by without symptoms
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Pressure is instantly worse when I bend forward as if to touch my toes
I was also told I have an enlarged emissary vein on the right side
And smaller transverse sinus
I beleive is all to due drainage issues from the jugular
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Sometimes I wonder if the stylohyiod calcification in front of c1 has anything to do with it
Or if it’s just my c1 which I know is anterior rotated to that side
Anyway hoping there’s a solution seen about 20 Drs so far and seeing a few more spine and neurosurgeon next week
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Definitely sounds like IJV compression symptoms. The heart racing is possibly your vagus nerve being compressed. It runs along behind your IJV. So if your IJV is compressed against C1, than your vagus nerve is likely compressed too. An important nerve for HR and BP stabilization.
I highly suggest sleeping with a pillow wedge if you aren’t already. I have the same symptoms as you I’ve been experiencing since September. Pillow wedge seems to help with the headaches and head pressure. Definitely helps me with sleep. Still get whooshing and the HR stuff and the dizzy. I think the dizzy is a combo between the IJV compression, and maybe the ECAs getting hit by the styloids with certain head movements that involve tilting the head upwards. This could be when the whooshing happens too. The ECAs supply blood to the ears, so if pressure in the ECA changes it’s possible that causes some of the tinnitus, ear fullness, and balance issues that could come along.
Have doctors been doing anything to help you correct the C1-2 instability? I wonder how much of your symptoms are being contributed by instability vs just chronic forward shift of C1? In other words, I wonder if a C1 shave would be better for you, or if stabilization (through exercises or a different surgery) would be better?
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@Deanm - Do you have an appointment set up with any of the vascular ES doctors we’ve suggested? Getting a consult w/ at least one would be a good idea. I remember you’re seeing one or two at USC. I’m very interested in what they tell you.
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Seeing Jeffrey wang at usc to assess the instability he’s a spine surgeon/ seeing Michael
Safaee at usc he’s a neurosurgeon to get his take on both issues / seeing Nestor Gonzalez who’s a head and neck vascular neurosurgeon at cedars Sinai / and telehetg with Peter costantino from your list
Trying pt and posture work for instability called PRI.. tried nucca and stem cells both make me flare up worse, only pri helps incrementally , I just went in for a standing refraction the exam supposed to help with the symptoms and calm the nervous system we will see.. I’m on month 4 I can’t imagine a year I need to get back to work asap.. if my body can regulate in its own within another 2-3 months that would be great otherwise I’ll
Do surgery .. a c1 shave may help … maybe other techniques to decompress… fusion would be worst case although I feel confident I could stabilize without it my neck doesn’t bother me really more of the head pressure and brain fog and off feeling ..
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It’s good you’re “leaving no stone unturned” @Deanm. Trying to get your cervical spine stabilized is a fine place to start.It would be great if your success prevents the need for vascular decompression surgery though having elongated styloids may eventually cause other symptoms to the extent you’ll want to get them shortened.
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It’s so hard to know what’s contributing to what with many members…I can sympathise as I had the head pressure, dizziness, constant off balance feelings, pulsatile tinnitus & brain fog…I was lucky though that mine was straight forward styloid compression of the IJVs & was resolved with surgery, I didn’t have C1 issues or instability. I hope that you’re able to get some answers and get an idea of the best way forward 
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Our symptoms are 100% alike makes me think it’s all from the ijv. Hoping there’s a solution like surgery that can fix it and recovery won’t be bad and I could get back to work , activity , exercise and normal life
How was your recovery
I really hope to get my life back sooner than later
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I’m
Seeing some small and slow progress with PT
My therapist says in 3 months I should be feeling much better I’m on my third week I am seeing a 10% improvement in symptoms so far.
I don’t know if I would “relapse” eventually and want to hear what the surgeons have to say
I’m willing to try PT another 2 months and if I’m not at least 50% better than I would heavily consider surgery
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How fast did your symptoms go away ? And what was the whole recovery like?
Do you have any scans of your compression? And who was your Dr?
I’m UK so I saw Mr Axon, he’s probably the most knowledgeable ES surgeon that we know of here. I didn’t get any scan images I’m afraid, both IJVs were pretty pancaked, the left especially so. I didn’t have too bad a recovery, but different doctors have different surgical methods- Mr Axon does an incision behind the ear & a little way along under the jaw, & says he’s able to go between muscles so none need to be cut. I was pretty stiff for a few weeks, & couldn’t open my mouth wide or chew for 10 days I think, but not in too much pain, other than the first night I didn’t need anything other than paracetamol. I was very lucky & the vascular symptoms eased considerably almost straight away with just the first side being done. I had to wait a year for the other side to be done, & only get the head pressure symptoms now if I fly, or get very stressed. I hope that the PT helps & that you can avoid surgery
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