Hi everyone! My doctor thinks I have vascular compression, resulting in high ICP.
I am on a Mac, using the Bee DICOM Viewer app. The export of 3D is either a large number of PNGs or MP4. MP4 video isn’t supported on this site, so I selected some of the PNG images. Let me know if there is a better way to upload / if these are useful.
Hello @azapppp, I am relativley new here so apologies if I won’t be much help. I loaded my images using Radiant, and had some success getting rid of the scanner bed in doing so. A quick google search shows that the Bee DICOM viewer also has this functionality.
My recommendation would be to remove the scanner bed and try and grt a closer look coming from the side view, with the styloids and C1 transverse process visible. Getting closer to these structures would also be helpful. You may want to angle the viewer so you can see the angle of the styloid behind the jaw, almost from a side/slightly back view. Many wonderful people on the site have been able to give me feedback on my images, so I am sure you will also be able to get feedback as well!
From your third picture it does look to me like the styloid might be elongated, but take that with a grain of salt while the experts way in.
I agree with @JGont , that with the angle & the jaw bone as the images are it’s not possible to say for sure if you have vascular compression. But certainly your left side does look longer than average, and it looks from what I can see as if there could potentially be IJV compression from other blood vessels as it looks like there’s a bit of a tangle in that area! The right side could possibly be elongated but you can’t see for sure, and possibly the IJV could be compressed as the styloid looks quite thick at the top… Bit obviously you can’t see the C1 process and if there’s any compression from this.
OK thanks so much everyone!!! I did a consultation with Dr. Brianna Cardenas, which was helpful. She showed me that my right styloid is overly long, but that actually most compression is happening on the left side and the right side is compensating. Let me know if you see anything else. She said likely both sides would be removed, but not sure which side the surgeon will prefer to remove first. I have my review of these with Dr. Constantino on May 13th.
YAY!! I can see your styloids & IJVs in these images. I’m so glad Dr. Cardenas helped you understand better what’s going on. Your styloids are quite pointed & the left one is very curved which likely explains its more intimate contact w/ your IJV even though it’s shorter than the right side. The right one is a little wavy along with being pointed. I agree that you’ll probably do best to have both shortened even if the right side isn’t causing significant IJV compression.
I’m glad that you’re seeing Dr Costantino! They do look pretty pointy, it doesn’t show so well in the 3D images but it does look as if there might be some compression from the C1 processes as well.
Also in the second image, maybe someone else can clarify if this is the hyoid curving upwards below the jaw? If so I would look into that as well, I can’t see the hyoid clearly enough in the 3D images?
