@JugularEagle - I remember you have a seriously tortuous ICA so you’re right. Your situation could be more challenging for a surgeon who didn’t know what (s)he was doing.
Hope it doesn’t take too long for you to get some answers, but good that you have ES confirmed by Dr Old!
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I need someone to make sense of this comment to me. Office of neurovascular surgeon is justifying doing NOTHING by saying neuroradiologist said there was severe narrowing which means the word stenosis but she didn’t use it but there is no occlusion in the neutral position . How can that CTA photo not have some occlusion . If you can see a severely trapped IJV it seems to me it warrants further testing in someone having strokes and brain bleeds.
Someone make sense of this because I can’t comprehend it
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This is clearly a case of ignorance on the doctor’s part or whoever it was in that office who decided doing nothing was the best step forward. I would say that once you get properly diagnosed & have surgery, that doctor/office needs an follow-up, informative letter from you, at the very least.
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I have asked for a second opinion. I am getting them to put on the record that they are doing nothing to help a person with a smashed IJV in the neutral position . I want their actions to be crystal clear and that I gave them MULTIPLE chances to help me through ENT and neurovascular departments
No person should ever face the nightmare that we go through. I am so disgusted
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Beyond frustrating how they think nothing needs to be done 
Sending you a hug 
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i thought i would give an update concerning Dr. Nakaji. First of all, their office has been very responsive. I asked them to send me info in writing because I do better seeing it in writing. When I hadn’t gotten back to them they called me back to follow up which I am impressed with. We have seen people not getting any response from some Doctor’s offices.
As I figured, there is likely going to be a hiccup due to his needing a venogram before he will operate which is problematic for me due to several reasons. I am going to have to navigate that but in the meantime, I kind of dont understand this statement. it would seem to contradict.
“no clear styloidogenic venous compression on either side with head in neutral, opacification of contrast is significantly delayed on the right suggesting a clinically meaningful cause.”
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@JugularEagle I think it means he sees compression on the right but he thinks it is being caused by something other than the styloid
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I agree that sounds like what they mean…
I agree w/ both @Chrickychricky & @Jules. Regardless of what looks obvious to your on your CT scan, Dr. Nakaji is seeing something else causing your IJV compression. There can be other causes of compression besides the styloid & C1. Among the possible causes of compression are local muscles, nerves, blood vessels, lymph nodes, ligaments, & scar tissue. Alternatively, your bony compression (styloid/C1) would be more visible w/ your head turned to the L or R but your head was only in neutral position for your scan so he wouldn’t say definitively (i.e. there is no clear venous compression…) that the styloid/C1 combo was causing the problem.
The fact that Dr. Nakaji’s office checked in on you alone says that there is concern with what he saw in your imaging. The upside of the venogram is, it gives him a much more clear picture of where the compression(s) is/are & potentially what types of compressors he’s dealing with before he makes the incision & has to hunt around visually.
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