I would really appreciate your thoughts on my 3D CT reconstructions.
From what I can see:
Right Side: The IJV looks almost entirely blocked between the C1 and the styloid. Not even visible. It appears that a collateral vein (likely the vertebral venous plexus) has enlarged to bypass the blockage.
Left Side: Shows a classic mechanical compression/narrowing.
For those who have had surgery or seen many of these, does this look like a clear case of ‘Styloid-C1 Nutcracker’ to you? I’m struggling with brain fog and left side pulsatile tinnitus. Thanks in advance for your opinions!
It looks like the C1 process is involved in compression of the IJV, but it looks like part of the calcified stylo-hyoid ligament is causing compression rather than the styloid process, not that this makes much difference!
In this image, it certainly looks like the looks like the IJV is almost completely compressed as you’ve said, it does look as if it reappears the other side of the styloid though away from the IJV, and I wonder if any other blood vessels are contributing to compression too, you can’t really say for sure from the angle though…
Certainly bilateral compression though- you’ve spotted all that yourself so didn’t really need our help!
Mr Axon at Addenbrooks does styloidectomy & C1 shaves, if you’re able to get a referral to see him?
He’s very interested in pulsatile tinnitus …
Yes I saw him in December and he said if my symptoms get worse, he can do the surgery. And yes they’re getting worse. I’ll also consult a neurosurgeon next week before deciding for the surgery.
