Opinion please

I know you aren’t medical doctors, but I want your opinions please. My second opinion Dr. says I don’t have elongated process and there is a portion on ct scan that has me confused. I thought one of ya’ll might have seen this before. It looks like an upside down cornucopia with something coming out of it. Above the cornucopia is something white wrapping around it. What am I seeing?

Picture 2 looks like a photo on a study showing the process was pinching an artery. What do you all think?

On the 2nd image, you can see the styloid clearly; it’s not particularly long, although has got quite a point on it so that could potentially irritate nerves.
Was it a CT with contrast you had? The part blocking the blood vessel you’ve marked with an arrow definitely isn’t your styloid, maybe a process from one of the cervical vertebrae? I’m not sure; it’s not in the right place for any piece calcified stylo-hyoid ligament either…Did the doctor not go through it with you? Puzzling, I’m sorry, maybe someone else can shed some light on it?

No he just referred based on the report from radiologist stating the ligament is partially calcified and the process is slightly long, but there was no measurement on the report.

I agree with all Jules said about the second image. I’ll add that there are several random white areas on your scan that could be bits of calcified s-h ligament, but nothing I see that looks like a solid mass.

As far as the upside down cornucopia looking thing & the long white area that extends from it, I have no idea. The long white thing looks like it could be something vascular. Your images aren’t as clear as some which makes it hard for us novices to know exactly what we’re looking at. :face_with_monocle:

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The first image shows what likely is the internal carotid artery. The second pic likely shows the transverse process of your C1 vertebrae. The styloid is exemplary short, I’d say, about 1.5 cm. It’s pointy but I’d bet inside the neck it’s covered with soft tissue, as the body might (source needed) be able to isolate naturally growing sharp ends of various bones with some isolation layer.
Btw in the second pic it’s likely the internal jugular vein. Veins don’t have muscular layer inside and have thinner walls than arteries, so they basically get compressed rather easily, in my opinion, based on watching videos where surgeons handle veins. That vein is kinda deformed by the C1 vertebrae transverse process, but it seems it’s not something obviously significant compared to the diameter of the vein portion leaving the skull. I’d even suspect that’s your non-dominating IJV and on the other side you’d find larger vein.


How about these? Crazy symptoms this week. I started with a sore throat. Then tongue turned blue and skin was turning purple. HR was really high and O2 dropped to 96. Dr sent me to ER. They couldnt find anything outside of tachycardia and called the purple coloring Raynauds. I could not stay awake. Then something moved in neck around c1 area and HR started dropping immediately.

I am not a doctor, but from my limited understanding about the body, that could be vagus nerve somehow compressed and does not properly send signal to the heart muscles to slow it down. Also it might be sudden blood circulation problem and the brain does opposite - reacts to the lack of oxygen/nutrients and deliberately tries to raise blood pressure.
Do you have MRI of your neck to see if there are no stenosis/hernia/atlantoaxial joint or atlantooccipital joint degradation?


Yes I do and there is some damage around c5 c6 area

Try to discuss that with neurologist, as it might be also contributing to the symptoms, directly or indirectly (e.g. it might cause tension in some shoulder muscles, which compresses the nerve or something like that).

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I can’t offer any comment on the images you posted as I’m not sure what I’m looking at but I can say I agree w/ vdm’s opinion regarding vagus nerve impingement or irritation possibly causing your symptoms. I had similar symptoms as part of my ES problems. When I did hard cardio exercise, my BP would drop & my heart would race. I couldn’t catch my breath & would feel like I was going to pass out. Those symptoms are mostly gone since I had my ES surgery.

Interesting about the Raynaud’s diagnosis. I thought that was specific to fingers & toes. Guess I was wrong! Regardless, it does sound like your symptoms are being caused by some sort of nerve or vascular impingement (which may only happen when your head is in certain positions). I hope someone you see orders the right type of scan to figure out what’s going on. If something is ordered, make sure the doctor requests that during the scan your head be in the position that makes the symptoms the worst otherwise, the scan may not offer any helpful information.

The 3D imager is pretty cool. Finally got to try it out tonight at work

If I’m looking at things correctly, the angle of your right styloid seems very steeply downward, & it looks very pointed though not terribly elongated. The greater horns of your hyoid also look like they may be a bit long, but I’m really guessing about that. Remember, it’s not always the length of the styloid but also the angle, how pointed, twisted or curved it is that can cause symptoms, too.

The images of your left side aren’t as clear. I’ve annotated what looks like s-h ligament calcification in the top image though I’m not sure if that’s your right or left side. I can’t see your styloid in the second image but have again labeled what looks like ligament calcification. In the third image, I’ve annotated your styloid process.

Here is a view from the other side of the hyoid. It almost looks like it is displaced. Arrows match up to the angles as if it broke off and ia hanging down.

Interesting thought. It does look like something isn’t right in that area. If not your hyoid, it could be the bottom part is something else that’s out of place. The whole hyoid is about the size of the upper piece at the tip of your arrow. Do you have any trouble swallowing? The hyoid moves w/ every breath, spoken word, cough, sneeze, swallow, etc., It would make sense that the hyoid is at least part of the problem if you have trouble/pain w/ any of those activities.

There is a doctor on our list who does hyoid bone surgery, Dr. Karuna Dewan, at Stanford in CA. If your hyoid is proven to be in two separate pieces, she might be someone worth consulting.

Yes definitely. Dysphagia constantly and the strange event where I moved something in my neck and all the trapped nerves in face woke up, vision returned, and jaw moved back into place was what finally made neurologist think eagles. He wasn’t sold on my miraculous recovery lol. I was constantly having neck pain and it feels like something is stuck in my throat. There was an issue w muscle in throat right in that area during swallow test. There is also a muscle going down the right side of back of neck that is constantly sore just below collar bone. It would make sense that something “broke loose”

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Just to add to that, it looks as if the C1 process could be causing compression in those images too. We have had a few members with issues there, either as well as the styloid process or instead of…

Another observation, Jjay76, is that you lack the kyphotic curve that should be in your upper cervical vertebrae (translation - where your cervical vertebrae come down out of your skull, there should be a slight curve toward the front of your body. You find this same type of curve in the lower back just above your pelvis). The lack of that curve may be causing some of the muscle tightness in your neck/upper back. It sounds like it might be your upper trapezius on the right that is tight. There are gentle neck exercises you can do to help relax the tight muscles. A PT w/ good neck knowledge could be very helpful.

The extra tissue just below your hyoid is a puzzle to me. It would be very worthwhile pursuing what that might be with someone who reads CT scans professionally. CT scans often contain artifacts which are lines or marks that don’t really belong to your body & are just incidental errors on the CT. It’s possible what we’re seeing is an artifact, but they are usually more discreet.

Here is an image of the proper neck curve & position of the hyoid bone. The styloids aren’t visible.

You are correct. The curve is gone. We were working on that which I think aggravated things and is what lead me back to neurologist for follow up. Thats definitely not an artifact because it shows up in multiple views and media. I am going to send it to the neuro to see his take and maybe my dentist. He is learning all about this now and would be interested. One other thing of interest I found by accident… Percussion massage will temporarily stop the feeling something is in my throat, fullness in ears, and alleviate neck pain. Range of motion increases too. Unfortunately it isn’t permanent but does usually buy a few hours.

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I think you are definitely right Jules. In some of the views it looks like its almost completely blocking circulation and definitely would if it was moving. I am guessing thats what happened last week when ox went to 96, HR was 120, and I could not stay awake until I got something up in that area to move around. Within 2 min I was wide awake with HR back down in 80’s. Its now stable between 70-80. Still tired but not like I was that day.

Just from what I could see. Your cervical spine lordotic curve seems to not really be there anymore (Military neck). I have the same thing and it has caused my brain to droop a ton t amount and my spinal cord to have a little bit of tension on it.