Opinion on my CTA that shows IJV compression

Wow the compression must have been quite bad to cause pulsatile tinnitus. I went back and read some of your posts before surgery and after surgery. Did you have really long styloids or just badly positioned ones?

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It’s not uncommon I think- my surgeon was Mr Axon in Cambridge, UK, & he’s done quite a bit of research into causes…My styloids were both 4cms, & I’m short so that makes a difference, there was quite significant compression on one side particularly.

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@Filatov - Thank you for sharing your opinion of @BlacknBlueSaint’s scans. We have found on this forum that nothing is black & white as far as what should/does cause symptoms & what shouldn’t/doesn’t. Therefore, since we aren’t doctors, it’s best not to unequivocally suggest that what you see in someone’s scan “does not play any role and does not give symptoms” as this may be true in some cases but not others.

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I have been on this forum since Sept. of 2014. I have learned a tremendous amount over the last 9 years about many health conditions our members deal with. I am not good at reading scans, & I’m not disputing what you say you see, what I want to convey to you is that you are speaking to our members in absolutes. You said what you see DOES NOT CAUSE SYMPTOMS. We CANNOT speak about the symptoms a particular scan image may or may not cause with absolute certainty. Every human body is created a little differently & so every human body will react differently to the stresses put on it. As I previously noted, when you say,

I do not believe that to true because of our different physical constructs.

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Dunning and Kruger would turn in their graves.
@anon67578920, read about Overconfidence effect - Wikipedia

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Have you ever heard about things like subclavian steal syndrome? Bow-hunter’s syndrome? Dozens of yet-to-be-discovered conditions and syndromes affecting hemodynamics during various head positions and movements?..

I think you perfectly described the problem here. You are very certain of yourself…

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You are very certain of yourself which I take as a good sign. I hope you have a lot of good neurologists, vascular surgeons and other specialists around you, and overall very good medical team, and they will fix your health problems promptly.
P.S. You don’t need to reply, don’t waste your time on an empty talk.

My friend, I don’t want to disappoint you, but I must strongly remind you that:

  1. what we know is limited. What we don’t know has no limits. Every time new ground-breaking discoveries are made, they challenge our world-view and established “truths”. That’s why we don’t do lobotomies anymore, we wash hands before surgeries, and we make sure our diet has enough Vitamin C. In the near future, our today’s thinking might look very simplistic compared to what we will have discovered in the future, especially if finally someone will figure out e.g. what gene is causing hEDS and how to treat it. I am mentioning this because patients with hEDS often “defy” existing knowledge and established investigation/treatment protocols
  2. You might underestimate the impact your assertiveness might have on people desperately looking for cure. They might desperately seek for a surgery that eventually turns out will have not been the root cause and suffer from consequences all their life. Also, based on your overconfidence, they may to decide to ignore something that is not present on the imaging in the supine position, but might start affecting the patient standing upright, or after the head is rotated, or in flexion, extension, flexion+rotation, half-rotation, tilting+rotation, oblique flexion, chin-tucking, chin-tucking and rotation, chin-tucking and flexion, chin-tucking and tilting, lateral flexing, lateral flexing and rotation and myriads of other head positions impacting hemodynamics. This is very evolving field simply because we don’t have established protocols and even measures for these examinations without using excessive amounts of radiation, contrast media, or dozens of hours with ultrasound scanner. So one day the situation will improve, but until then, please bear in mind that today’s radiological examination have their both theoretical and practical limits.

And remember, you might be right in 99 cases out of 100, but that one wrong case might cost someone their life.

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and do you even know that in a lying position, 75-85% of the blood flow flows through the internal jugular veins, when standing opposite, 55-65% flows, and the rest through the vertebral plexus of veins.
so just in the supine position, this is the best position for examining the IJV.

and again you are not fully aware. And in any case, all assumptions will be checked and additional examination or study of existing images will be done.

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.