Hello everyone,
I am pretty new to this forum. I stumbled across it when I was trying to figure out what could possibly be going on with my health & have been reading posts and checking things out for a bit. I told my husband, “I found my people” because I began reading that many of you have experienced the same symptoms I had but that my doctors had not yet figured out. I did have one neurosurgeon say that I had internal jugular vein compression possibly due to Eagle syndrome (which I never heard of) but that it wasn’t something I needed to investigate until my symptoms worsened. I did begin investigating though because I have several symptoms & was a little concerned about my IJV being compressed & possibly impacting blood flow from my brain. Well, after MRA, MRV, Cervical x-rays, CTAs of head & neck, I was finally told that I have bilateral elongated styloid bones with calcified ligaments as well as extra wide transverse processes that are impacting both internal jugular veins. It looks like surgery is the only option that I have at this point in order to make room in my skull for things to work like they are supposed to. My symptoms have included head pressure, headache, oversensitivity to noises, neck pain, jaw pain, blurry vision and pulsatile tinnitus. All symptoms occur on the left side, although the doctors say that my right side jugular shows more compression. It is also strange because the symptoms are intermittent, daily, but not all day long ( which I am very thankful for). I have also noticed improvements with postural changes. Anyway, I realize that this is a very specialized surgery. I had a consultation with Dr. Constantino in NY who brought Dr. Tobias into the meeting while I was there. They both feel that I need the surgery and were very thorough in the explanation of what is going on and what the surgery involves. I cannot move ahead with scheduling surgery yet because I need to have a neuro-ophthalmologic examination to rule out papilledema. Of course, I was told that the neuro doc is scheduling out a few months, but am hoping that I will be able to get in sooner since I would like to get the surgery completed & be able to recover before the new school year starts in the fall. Anyway, I am wondering if any of you who have had surgery with Dr. Constantino will fill me in on your experiences. He was very positive and said that they have had many successful outcomes. He also made it seem that recovery would not be too bad, but I have read some stories where recovery was pretty tough. I would appreciate any info that you all can provide regarding your experiences with Dr. Constantino. He seems to have done quite a number or these surgeries and stated that they are always looking for ways to improve the techniques that they use to maximize the positive outcomes for the patients. Thanks so much!
Here is a YouTube series created by our member @Barrootz which is based on his experience w/ Dr. Costantino. I think you’ll find it helpful, @vap
After you’ve checked out my site and videos, feel free to reach out with any questions. I also suffer from dizziness and vertigo. My jugular vein decompression resolved a bunch of my issues (brain fog, nausea, hangover feeling) but not my vertigo. I’m being checked for SCDS (superior canal dehiscence syndrome in a few weeks.
So pleased for you that you’ve been accepted for surgery! Praying that you can get in to have your eyes checked sooner- are you on a cancellation list? 
Thanks for reminding me about a cancellation list. I usually ask to be put on it (along with a lot of other people I think) but I haven’t even been able to speak to someone who was willing to schedule the appointment yet. Thankfully, Dr. Constantino’s assistant was able to fax the referral over to the neuro-opth doctor on Friday morning. I’m hoping that I will hear from them soon to see about scheduling that appointment. I was told that I need to have the eye exam before they will schedule the surgery.
Thank you for sending me the link. I will definitely check it out. Even though I felt comfortable with Drs. C & Tobias, I think that I should probably get a second surgical opinion just to see what another surgeon would say. When I met with Dr. Hackman a couple of months ago, he didn’t tell me that I had bilateral involvement but said that I was a candidate for surgery. If you have any recommendations about who to get a second opinion from, I’d appreciate it. I think that Hepworth seems pretty busy & might take a while to get an appointment, although it seems that his patients are very pleased with how he does things. I do know that Dr. C said that I will need the styloid removed & C1 shave because there is so little space in that area.
Thank you! I will check out your information. I appreciate your willingness to answer questions that I will probably have! I’m glad that many of your issues were resolved, so I’m sure that is a relief. It’s probably frustrating though that the vertigo is still there. I’ve only recently experienced the vertigo rather briefly but it sure was weird & I hope it doesn’t happen again.
You may have just had an episode of BPPV. Wow, it is frustrating and scary. It is harmless. It’s just when a crystal gets stuck in the balance portion of your inner ear and obstruct the fluid from moving freely. There are different maneuvers you can do if that ever happens again to reset the crystal. Eppely maneuver, half somersault, etc.
Thanks! I never heard of BPPV, but looked it up just now. Hopefully it won’t happen again. I had been looking down reading something & then looked up quickly. The doctors have told me that it is very tight on both sides with the compression & that the best position to maximize blood flow is probably straight ahead, not looking left or right or up or down…That makes it a little difficult to do a lot of normal things.
@vap similar story actually, i have predominantly left sided symptoms but right jugular is more severely compressed.
It is a bit confusing to me as to why that is. The dr. mentioned that my left side is dominant and so maybe that has something to do with it. He also said that he would choose to operate on the left side since my jugular vein on that side is larger and would therefore allow more blood flow than if he operated on the right side. Have you decided what you are going to do?
I had significant vertigo over about a 7 year period. When I learned about the Eppley Maneuver half way through that time, I tried it during one especially bad bout of vertigo. It made my symptoms worse. What I found worked best for me was either walking (yes, I looked like I was drunk) or sitting & watching TV (which I typically don’t do). It seemed if my eyes were kept busy/had something to focus on, it helped stop the nystagmus & ultimately the dizziness. After an especially horrible 2 day vertigo attack in 2022, my vertigo abruptly stopped. I have no explanation for why, but I’m very thankful.
Besides Dr. Hepworth, the only other doctor on our list who’s been noted to do vascular compression is Dr. Breeze who is also in CO. We have a few members who’ve seen him for ES surgery. You can search for their posts using the magnifying glass search tool & typing his name in the search box.
•Dr. Robert Breeze, Neurosciences Center - Anschutz, 1635 Aurora Ct 4th Floor, Aurora,
720-848-2080, Robert Breeze, MD | Neurological Surgery
Thanks so much!
Not yet, taking some time to think. My symptoms are not debilitating and fluctuate similar to yours actually. My headache never disappears but yes brain fog is fluctuating. So hard to know whether to take the risk on surgery.