Morning!!
I believe this topic was only brought up once, about a year and half ago. I’m reaching out if anyone has any new insight.
Full disclosure: I just had surgery with Hep last month. He did a left decompression, styloid, vagus nerve untangling, removal of lymph nodes, scar tissue, took off 6mm of my C1 and septoplasty.
My question is: on all my previous head/brain imaging, it shows dilated perivascular spaces bilaterally with white signal hypertensities, including the right internal capsule and enlarged space in the medial right basal ganglia. One report states upper cervical paraspinal venous collaterals.
I am assuming these are all collaterals. I have a lot of head pain and I turn like a robot. I am hoping these collaterals will shrink in time and looking to purchase a red light device. I guess my question is, have these shown up on anyone else’s imaging/reports?
I know we’ve had members with some of the co-conditions you’ve mentioned, but I don’t know if anyone had all of them (don’t you love being unique?! NOT!). The only thing I can offer is that it’s thought the collaterals do shrink when they’re no longer needed, but I don’t know of anyone who’s actually gotten follow-up scans to check for that specifically. I’ll also add, what you most likely know - for people w/ bilateral IJV compression, it often takes decompression of both sides to get rid of the headaches & other symptoms (in spite of doctors saying having only 1 functional IJV is all that’s necessary).
Did taking a blood thinner prior to surgery help reduce your symptoms? If so taking one post op has helped some people get through the first few months of recovery w/o as much head pain/pressure/brain fog, etc.
Thx for the reply. Brilanta and Plavix did nothing prior to surgery. I’m assuming the imaging along with the reports, all mean the same. Collaterals. Hep did the left side but his initial summary indicated my right collateral vein has construction at base of skull affecting my jugulars. He said my right jugular is compressed profoundly between C1 process. Hurts like a mother…..
Getting the second side decompressed will go far toward helping get rid of your headaches, pain & other related symptoms though it may still take a few months even after the second surgery.
I have/had significant collaterals, too, (don’t know their current status), & in retrospect, I bet they’re what caused my occipital pain to go on for so long after I had my first two surgeries.
I have so much going on in that area, hard to tell. Hearing loss, mastoid effusion. constriction at base of skull and a bone spur. It could be the bone spur causing my head not to turn. Who the heck has a bone spur at C1??
That’s rough, and so hard to know what’s causing what… 
Sorry about the bone spur. I suspect you may be right, though, it could be a contributor to your pain & lack of head mobility. Did Dr. Hepworth comment on it i.e. can it be shaved down?
I have not yet discussed as it was the opposite side surgery was on. I have a telahealth in May. I have been trying to set an in person appointment this Summer and to do repeat ultrasound. I am being ghosted. Office still sucks.
I’m sorry about the ofc situation. I know it’s really irritating & don’t understand why such a competent doctor can’t seem to maintain a more competent or at least more efficient office staff. Several of us have joked about moving to CO so we can get his office straightened out & working efficiently. 
Be persistent about calling & emailing. You’ll get what you want/need eventually, but I’m sorry it’s such a chore.