Hi Sprinter, (CC: @Isaiah_40_31 for directing me to your post)
I am reviewing your CT scan now.
Your IJVs are healthy and normal with good bilateral flow.
Your symptoms sounded so much like mine so I wanted to check for hyoid bone syndrome. When the tip of the hyoid bone presses on the carotid artery it can cause all of the symptoms you describe.
Your right greater horn of the hyoid bone is very close to the internal carotid artery. Keep in mind on the CTA what we are seeing with the artery is the blood flow through the artery, you cannot see the outer wall of the vessel itself. It is highly likely that in reality the hyoid bone is pressing up against the carotid artery and this artery is highly innervated so it can cause a lot of symptoms. The condition is easily treated with a hyoid bone resection and you can test it by palpating the hyoid bone to see if it provokes symptoms or if the tip of the hyoid bone is tender on that side.
You also have these wild loops in your internal carotid arteries, unlike anything I’ve ever seen. This can’t be good and I would highly recommend getting a consult with a vascular surgeon to discuss. On the right side the loop is where the styloid process is:
l hope this helps,
-Connor