Surgery with Hepworth coming up in early May

@akc Great news that things are going in the right direction. I think every compression has somewhat unique features or types. For example, one might have the usual Styloid/C1 compression and in addition might have Digastric muscle & Occipital artery compression as is the case with me and also @Barrootz who luckily had all those compressions taken care in one surgery by Dr. Constantino & his Neurosurgeons ( Decompression surgery with Costantino - #35 by Barrootz). Where I went through 2 surgeries (one for the Styloid 2022 & one for C1 shaving 2023) but I still have Occipital artery/Digastric muscle compression remaining on my dominant left IJV. There was a lady (@BriCSP ) that had Styloid/C1 and also accessory nerve compression on her IJV and it turned out that accessory nerve was doing most of the compression (Surgery with Dr. Costantino and Dr. Tobias on July 24—not quite Eagle's - #13 by BriCSP). She was lucky and it was all taken care of at once and as result her 10+ years migraines were gone.

Reason why I am alluding to these cases is that, many of us do not improve after Styloid/C1 compression removal because we have other compression that doctors might not be aware since some could only be seen dynamically and can only be seen with large incisions such as the one Dr Constantino performs.

So in your case, Not a doctor, but I think you might need both Styloid removal and C1 shaving on your left dominant IJV since both appeared to be compressing your IJV somewhat. You could also improve with only Styloid removed so I am not discouraging you but preparing you so that you do not feel disappointed if you do not improve. Additionally, I saw what appears to be Arachnoid granulations (appears dark holes in the TSs) in both of your transverse sinuses (see my excerpt of Sept 2023 findings) which appear to be moderate in size. Not a doctor again, but at some point, you might need to address your transverse sinuses’ arachnoid granulations to have a fully patent TS + IJVs .

You said Dr. Fargen found multiple compressions, I wonder if he said anything about your transverse sinuses? Do you have his report?

Anyways, my point is, this is a journey and depending on one’s compression type & complexity and luck (@Barrootz & @BriCSP were lucky to have all the compressions removed in one shot), you might get relief in the first operation like many folks here, if you don’t, don’t despair, but know your compression type and address them one by one before thinking of stents or shunts as Dr. Fargen is dead right on what he said about them. Stents are good options if you have transverse sinus compressions according to the peer reviewed studies I read but not so for IJVs. Wish you all the luck.