Hi Everyone, I wanted to reach out and say hello! I just started on this journey last month but I think I have been on it for a couple years. I was in a car wreck a couple years ago and have had back and neck issues and a concussion. The pain immediately after the wreck was pretty bad, however, I have found ways to manage it better today. Today I am left with the following symptoms, but some may be attributable to the cervical spondylolisthesis and concussion:
Confirmed long and thick left stylohyoid ossification CT
Throat lump with swallowing
Throat discomfort specifically with left rotation
Tenderness under left jaw
Left neck deep ache
Left temple migraines — exercise triggered (had migraines non-stop after the wreck initially but they have declined to being predominately after exercise)
Recently syncopal episode followed by significant left sided migraine. Unaware of what triggered this but I suspect it is vascular eagle syndrome. ER workup was negative. Naratriptan didn’t work very well to control the migraine. Naratriptan has been the best intervention for the migraines but it doesn’t always work. Have also failed b2, mag oxide, and propranolol.
Left sided workouts trigger headache/pressure in head
Head and Neck feel better when laying down
Tinnitus left side
Heaviness behind eyes
Heaviness at base of skull
Turning left does not feel mechanically smooth
Your symptoms certainly sound as if you could have vascular ES, more likely carotid compression from the migraines and fainting…although some symptoms like the heaviness at your skull base, and pressure in your head could be IJV compression. As the IJV and the ICA are close together, it’s possible. If you’re able to request when you have your contrast CT for this to be timed to show the arterial and venous phases in your neck, this would be helpful to see what’s going on. Sometimes it’s possible too to get a dynamic CT, so if you could ask if it’s possible for you to also be scanned with your head towards the position which causes fainting, that’s useful too… (If you know, often turning your head to one side or looking up or down can cause this)
MRIs don’t always show the styloids very well, & we’re not experienced with reading those images on here, but if you have the imaging from the MRA you had, you could have a look & see if you can see any obvious compression- you would think that radiologists would pick this up, but they don’t always!
Once you’ve had your scans, you could make sure you get copies, and then perhaps it’s worth sending them to one or two of the VES doctors? Like Dr Costantino in NY, Dr Lui in NJ, Dr Cognetti in PA?
Once you get your CTA, you’re welcome to post some images here. If you can convert them into 3D first that would be helpful. We can give an opinion as to whether we think everything is normal or not. Some radiologists are rather casual about what they mention seeing in CT imaging, & things we know are important are missed.
As far as your symptoms go, all are those seen w/ ES so it’s hard to say whether your neck injury is generating some of them or if they’re all from your styloids. I had vagus nerve symptoms during hard aerobic exercise i.e. my blood pressure would drop, instead of elevating, which caused my heart to race which in turn made me feel like I was going to pass out. I also had a feeling of severe pressure behind my left eye, so much so, I felt like it was being pushed out from behind. I’d check the mirror many times every day to make sure it was staying in place. Both the exercise symptoms & the eye pressure as well as other symptoms resolved over some months after my styloids were resected.
Hi everyone, I attached the cervical images that the ossification was first noted. I obtained the image from a dental x-ray from a few years ago. Can you see the ossification on the dental x-ray?
I can’t see anything either in the images. The pano x-ray is really dark which may be why we can’t see your styloids plus the right & left sides are cut off so your whole jaw isn’t visible which also cuts off the area where we’d be most likely to see the styloids.
Hello @mememereally and welcome. Your symptoms sound very similar to mine. I had a car accident around 9 years ago and have been having left sided symptoms for two years that match yours, altough I believe some of the nerve pain has been there for much longer. I never suffered migraines previously and it was the onset of these debilitating daily symptoms, all left sided that led me to get some imaging. After a long journey of being told my CT with contrast was normal, my elongated left styloid and IJV compression from C1 was picked up on this forum. I am a couple of days out of surgery for left styloidectomy and C1 TP resection, so time will tell.
Hopefully you will be able to get a CT with contrast mention here and you then should have access to detailed imaging to show what is going on. Best of luck.
