@jakef8 - When you post imaging, please make sure you cover your name so it’s not visible in the pictures. I did this for you on the ones you just posted.
Your symptoms definitely sound vascular & like a mix of both IJV & ICA/carotid with the symptoms you’ve listed. Unfortunately, it looks like your images were taken w/o contrast which means your internal jugular veins & carotid arteries aren’t visible. I also couldn’t see your hyoid bone which would be helpful as the carotids can be compressed or irritated by the greater horns of the hyoid, but the IJVs are more often compressed between the styloid & C1 though sometimes soft tissues in the neck can also be contributors.
Do you also have images of your right styloid?
Here are my annotations & some discussion about what I see:
Your left styloid is very long & looks to have an inward curve. Your C1 vertebra is quite a “differently shaped” than I’ve seen, & you have ponticulus posticus AKA arcuate foramen which can cause symptoms but doesn’t always. The left transverse process (TP) of C1 is very thick & oddly shaped. Though the distance between C1 & your styloid doesn’t look super tight, you’ll see in the next image that your left IJV is a flattened oval which means it is being compressed.
You’ve also lost the lordotic curve in your cervical spine which brings the styloid & hyoid bone closer to vascular tissues & nerves in your neck. The curve can be restored w/ gentle PT exercises but it takes much time & perseverance. Some of our members have tried working on that project prior to their styloidectomies but some prefer to wait until afterward. See the info in this post for help with this: List of my favourite resources on YouTube to learn anatomy
In this image you can see the flattened oval of the left IJV, however, the space between your right styloid & TP of C1 is so narrow that I can’t see the IJV there. It’s likely very flattened. In addition, you can see how much wider your right TP is than the left one which is likely why there is far less space for the IJV to squeeze between the styloid & C1 on the right.
The IJV & vagus nerve are side by side w/in the carotid sheath as they pass between the styloid & C1 so when the IJV is compressed, so is the vagus nerve. The vagus is the largest & most far reaching of our cranial nerves & affects many of the body’s functions. I suspect that some of your symptoms are also coming from your compromised vagus nerve.
The two closest doctors to you who can help you are Dr. Costantino in NY & Dr. Liu in NJ. Instead of wasting time & $ on doctors who aren’t being helpful, you can schedule a consult w/ one or both of these doctors. I believe both do telehealth initial consults so you wouldn’t need to travel to see them until you decide about surgery.
•Dr Peter Costantino, 4 Westchester Park Dr, 4th floor, White Plains, (914) 517-8056
http://www.nyhni.org/find-a-physician/Peter-D-Costantino-MD,FACS
•Dr. James K. Liu, 200 S. Orange Ave, Ste. 265, Livingston NJ, Dr. James K. Liu | Top Neurosurgeon in Livingston, NJ
