How to locate an osteophyte

EDIT: I may have found it. See my reply below.

Hi again, I was wondering if anyone can help me look for an osteophyte growing around my vertebral artery? I believe it would be my left one, since the right one has severe hypoplasia. I have a CT angiogram that I uploaded to DICOM library if that would show it (see below), but the original doctor who found it was looking at my CBCT scan, so let me know if I should upload that instead. I’m not seeing that doctor anymore because he’s out of state, but I am now wishing I had a picture of it to bring with me to my upcoming appointment with a vascular surgeon.

As for an update on my other stuff, I saw an ENT about the hyoid bone entrapping my right carotid artery and he agreed it is a problem and had no issue doing the surgery, but he said the vertigo I am getting that lasts for 6 to 8 hours when I move my head in the wrong position, or when I try to lie down to sleep, he is not convinced is being caused by that hyoid issue. He said he can clamp the carotid artery for surgery all day and it wouldn’t trigger that type of vertigo, but the vertebral artery would absolutely cause that. So for now he is wanting to do more testing and have a vascular surgeon do dynamic testing to look in my arteries and see where things are being pinched. Then we will go from there, so I will update the group when I know what’s next. The ENT said, he just doesn’t want me to go through surgery only to wake up the same way, so he wants to make sure we get the right problem figured out and fixed.

Here’s the post with links to my CT scan:

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Does this look like the osteophyte? Do you think there is any way this could be causing the extreme vertigo when I try to lie down or when I turn my head the wrong way? Any other ideas what can cause the below symptoms based on my other post I linked to above and what others discovered? Any tests I should ask the new doctors for? I have an ENT and a vascular surgeon.

Here’s what i experience:

When lying down:
Instantly I feel an extreme increase in head pressure and a strangling feeling in my neck and my heart starts pounding. I feel chest pain and stomach pain. Then I start feeling a vibrating sensation at the base of my skull that causes my body and limbs to feel weak. Then vertigo and/or violent spinning starts. I get soaked in sweat instantly. Brain feels on fire, nerves and body feel on fire. My ears start ringing and I hear my pulse in my right ear. My vision blurs. I feel extreme confusion and feel like my words and thoughts don’t make sense. I know I should get up but the confusion makes it hard and it feels like I don’t know how to move. If I don’t get up at that point I black out, then a surge of adrenaline wakes me and I feel like I was almost dead.

When upright:
Constantly feel a lot of pressure in my neck, eyeballs, and head, like the kind of pressure you’d feel if you were hanging upside down. The pressure in my neck goes all the way down to my collar bone area and makes me feel like I need to cough. If I bend down, like to put my hair in a towel, then the pressure increases a lot. If I move my neck wrong, which is usually like if I’m kind of hunched down and rolled forward with my shoulders and then turn my head to the right and look up, it makes me begin to pass out and can trigger a severe vertigo episode that lasts for at least 6 to 8 hours.

I am only able to sleep fully upright, no reclining at all due to symptoms. As soon as I lean my head to the side to rest against a pillow, even just slightly leaning with very little pressure, it begins to trigger the vertigo and tingling feeling at the base of my skull and upper neck. It is actually worse when I lean toward the left side. The tingling feeling seems to happen with even a light pressure against the back or side of my neck.

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What you see on the transverse process of your C-1 vertebra could be the osteophyte you’re looking for. The TPs of C-1 don’t typically look like a hook, but yours does. That could be causing at least some of the vascular problems you’re having. Most of your symptoms sound like they have vascular compression components.

I don’t know if you saw the posts @vdm made today, but here is the link to them as they may be relevant to you as your cervical spine looks pretty straight: Military Neck and effects on Vertebral Arteries

I must say that your ENT sounds like a great doctor. You must really appreciate how thorough he’s being & that he doesn’t want to jump in & do surgery until he’s sure he’s got the full picture of what’s going on in your vascular system. That makes a lot of sense though having to go through more testing may not be your first choice.

Reviewing the information that @GCD & @KoolDude gave you in the post you referenced reminded me that your situation is complex. I hope the doctors you’re seeing get to the bottom of what’s going on ASAP so your care can progress & you can begin recovering. :pray: :heart:

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@BlacknBlueSaint it looks a bit like Arcuate foramen | Radiology Reference Article | Radiopaedia.org though I might be wrong. I haven’t checked the other images

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Thank you! @Isaiah_40_31 I really appreciate the input and the link to the other post. That is very interesting about the military neck, etc. and the symptoms sure seem to line up. My original doctor, who is out of state, also suspected vertebral compression, so he did a doppler vertebral study, which did show reduced velocity in some positions, but he isn’t a vascular doctor, so can’t help me any further. We also discovered I have severe right vertebral artery hypoplasia, so that might be part of it.

I am very glad they’re being so thorough and looking into this more, but at the same time it’s already been over 9 months since it started and over 7 months since I’ve been able to lay down at all, ever, so I am beyond weary! More time and more waiting and I’m struggling to hang on.

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Interesting! I will look into that more and see if it can cause problems with compression. And I’ll ask the vascular surgeon, too. Thank you!

I finally found the notes from that appointment and it’s apparently called a ponticulus posticus.

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So sorry that you’ll be needing more testing, and that it’s so complicated…praying the doctors find the solution :pray:

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Thank you so much! :two_hearts:

Yeah, that’s another name for arcuate foramen

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Good to know, thank you! :blush:

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@vdm - thank you for this link & a look into something else I knew nothing about though I think arcuate foramen has been mentioned before. Super interesting!!

@BlacknBlueSaint - I’m sorry your journey of discovery must continue, but I’m praying in the end, w/ a proper diagnosis, your symptoms can be treated & will resolve.

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@Isaiah_40_31 thank you so much! :blush:

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