Opinion on my CTA that shows IJV compression

The reality often is different, even though you might not believe it (and I don’t blame you, because the vast majority of folks here are on the same boat - they could never ever believe of so much negligence, ignorance and short-sightedness in the medical field.)

People here, on this forum, are here mostly because the “mainstream” process didn’t work for them, and they are more exceptions than typical cases.

Typical cases get fixed by mainstream thinking doctors and live their happy life without being on forums like this.

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It’s just an observation based on limited number of perfectly healthy individuals. Emphasis on perfectly healthy.

In many cases of less healthy individuals, the body may develop collateral veins taking over. Or may not, which starts causing blood circulation and CSF absorption issues.

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conversation about nothing/
What do you think, “genius”, if I know the structure of the vascular system, then I won’t know about collaterals? :smile: and I know about errors in medicine and the amateurish approach, which is why I studied some aspects of medicine.

I obviously can see that you know a lot about the vascular system, and perhaps much more than the vascular aspects of the anatomy, also I can see that you understand how amateurish approach in medicine might be, and therefore I am sincerely astonished that you are not immune to the same biases and fallacies those amateurs fall into…

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Either there’s a language barrier here where you are reading @Isaiah_40_31 @vdm tone as hostile or we are reading yours, but either way, just a word of advice, try keep things non confrontational. This is a support group, not a medical debate council. You could be very knowledgeable and even right about a lot of what you’re saying, but there’s a way to go about it and your way is not the way.

I think you can provide a lot of value because you obviously know a lot, but my hunch is that if you keep up confrontational demeanor then the mods may step in and that would be a lose lose for everyone.

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@anon67578920 I did upload my scan to DICOM here:

Also, I’ve recently done a dynamic cerebral angiogram and the doctors were surprised that it showed excellent blood flow in my brain and neck, so now they think the issue is a nerve, potentially the vagus nerve, being irritated when I put pressure against my head and neck.

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@anon67578920

I agree with @elijah that it seems you have a lot to offer but your delivery method is very confrontational. Try not to make it personal or come across so harsh when speaking to others. You have value here but your delivery could be much kinder and not condescending. Nobody is a doctor here, we are just sharing our own experiences and knowledge to try to help people know what next steps to try, but we all know that these are not professional opinions, so we take this info we get here with a grain of salt and then seek out a trusted doctor. Most of us here are suffering intensely and have been for a very long time, and this is where we come to be heard and understood and receive support. Kindness is essential here.

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I’m already tired of explaining the same thing to you, if you were a technical specialist, you would understand. This concerns the vertebral artery. I’ll just tell you, according to the vertebral artery, the total blood flow is 160 ml/min (± 60 ml/min). And in the common carotid arteries 600-700 ml/min (± 250 ml/min). Do you really think that the middle cerebral artery cannot compensate for 50-80 ml/min, when one VA is hypolplosed ? There were cases when one common carotid artery was almost completely thrombosed, and the second + VA compensated for the lack of blood flow and the person practically did not feel severe symptoms.

Very well spoken, @vdm. Thank you.

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@BlacknBlueSaint - Thank you for sharing the heart of this forum so compassionately & concisely in your post.

@elijah - Thank you for acknowledging the potential language barrier. Since our forum is available worldwide, it’s inevitable that we may not always fully understand each other, however, we do our best to try.

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Well, I completely agree that in many typical, “healthy less one hypoplastic vertebral artery” cases the patient has no severe symptoms. The complexity and possible effect might start emerging later in life, when intervertebral discs start losing their flexibility and height, when ligaments become less stable or opposite - stiffer (depending on individual body’s abilities to produce healthy collagen), when osteophytes start growing putting limits on how freely the vertebral arteries can move/slide inside the “canal”, how well developed CoW is so that no aneurysms develop, etc.

What I am trying to say, our bodies are not “created by design” but evolved, and the vast majority of medical knowledge is gathered by observing the subjects rather than reading the design blueprints and stating “this is how it must work, everything else is wrong”. Most common varieties are called “anatomical variations” which are well documented and classified (including CoW anatomical variations, IJV, VA anatomical variations etc.)

The issue is that there are more potential anatomical variations than we can imagine, and the body might have developed some very individual redundancies to cope with that. The problems start when some of those redundancy mechanisms start to fail, and some “anatomical variations” of those redundancy mechanisms are more prone to failure than others.

Basically, the numbers you mentioned are based on observations, but we don’t know if they are optimal numbers for every instance. What if someone has sickle cell disease? What if someone has anemia? What if someone used to live in high altitudes and their brains got used to semi-hypoxic state? What if someone is pregnant and more blood needs to be passed to the fetus? What if someone had radical dissection due to the cancer and lost one of the ICAs?

There are more “what-if’s” than we can imagine, and that’s why there are so many so called “rare diseases”, and even more to be discovered, I hope, as we still have too many sick people who can’t figure out what exactly is going on despite enormous amount of examinations.

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I like how you think, @vdm, but I do have a question. What is CoW?

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Circle of Willis.

CoW aneurysms due to developmental issues, from what I remember, are often fatal, as it’s very hard to successfully operate on them.

Btw there’s a fresh article on correlation between CoW anatomical variations and certain intracranial aneurysms:
https://www.sciencedirect.com/science/article/pii/S0022510X23002010

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Thank you for clarifying. I probably could have figured it out if I’d referred back to earlier posts. :crazy_face: Just call me lazy.

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It’s interesting though as one radiologist about ten years ago confidently stated that on MRI he saw hypoplastic posterior communication arteries in my CoW.

Later scans, esp. CTA, always came as “normal appearance CoW”. I don’t have those old MRI images, also MRI/MRA (without contrast) isn’t the same resolution/clarity as modern CTA can be, so I am not sure if my CoW just evolved, or the first radiologist was wrong, or the old MRI scan didn’t catch it right, or later radiologists somehow differently interpreted the same reality. Maybe criteria changed and what used to be seen in my case as “hypoplastic” in the past, now doesn’t match the criteria anymore.

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@vdm, Whatever the case, I’m glad it’s normal now.

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Just for those who are curious what the CoW looks like:

Warning: graphic images. Click to reveal.

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