# Type of CT for VES **URL:** \ **Category:** Symptoms and Treatments\ **Created:** [April 26, 2023, 4:02pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272 "2023-04-26T16:02:39Z")\ **Posts on this page:** 6\ **Page:** 1
**Author:** ![Leah](https://avatars.discourse-cdn.com/v4/letter/l/c89c15/32.png) [@Leah](https://forum.livingwitheagle.org/u/Leah)\ **Post date:** [April 26, 2023, 4:02pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272/1 "2023-04-26T16:02:39Z")
Believe this is from Isaiah … "A CT with contrast is generally used to diagnose vascular ES (compression of the internal jugular vein or internal carotid artery by the styloids). Since a CT w/ contrast shows soft tissues as well as bony structures, it can be harder to determine styloid length & other features of the styloid that might cause symptoms as the soft tissues can partially cover the styloids & s-h ligaments." Assume since I have vascular symptoms need CT w contrast as a higher priority over possibility of not getting good images of styloid and ligaments? (of course trying to reduce radiation exposure and need for additional CT). Thank you ---
**Author:** ![Jules](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/jules/32/404_2.png) [@Jules](https://forum.livingwitheagle.org/u/Jules)\ **Post date:** [April 26, 2023, 4:34pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272/2 "2023-04-26T16:34:06Z")
I think if you have Vascular symptoms the best scan would be a CT with contrast- ideally if symptoms are worse with a particular neck position if you could have it done like that, but that’s not always possible…It should still show the styloids & any calcifications well enough. ---
**Author:** ![Leah](https://avatars.discourse-cdn.com/v4/letter/l/c89c15/32.png) [@Leah](https://forum.livingwitheagle.org/u/Leah)\ **Post date:** [April 26, 2023, 4:39pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272/3 "2023-04-26T16:39:15Z")
thank you so much! regarding positioning … is it something the ordering dr puts on the order? From another post … > **[A rare vascular complication of Eagle syndrome highlight by CTA with neck...](https://www.sciencedirect.com/science/article/pii/S1930043320302296)** > > We report a case of a 53-year-old woman admitted to the emergency department with left hemiplegia, tinnitus and palpitations. A cerebral and cervical … temporal styloid processes To support our hypothesis of a stylocarotid impingement, a cervical **CTA with hyperflexion (45°) of the neck was performed.** It clearly revealed the bilateral impingement between the styloid processes and internal carotids. ---
**Author:** ![Isaiah\_40\_31](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/isaiah_40_31/32/3054_2.png) [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)\ **Post date:** [April 26, 2023, 8:06pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272/4 "2023-04-26T20:06:51Z")
Head position during a CT can also affect the extent to which the jugular veins are compressed. A neutral head position can reveal that nothing is wrong whereas having the head turned one way or the other, or up/down, can tell a different story. Again, being able to have your head in the position that causes symptoms to be more pronounced is the key. If a CT w/ contrast doesn’t show vascular compression of any sort, a follow-up angiogram can be done to check blood flow volumes through the veins/arteries. These can be done w/ the head in the position that provokes symptoms. I’m not sure whether your symptoms are indicating IJV vs ICA compression. A CT scan can be done both w/o contrast & w/ in one scan session. It must be requested by the prescribing doctor though. ---
**Author:** ![Leah](https://avatars.discourse-cdn.com/v4/letter/l/c89c15/32.png) [@Leah](https://forum.livingwitheagle.org/u/Leah)\ **Post date:** [April 26, 2023, 8:24pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272/5 "2023-04-26T20:24:09Z")
Interesting … ok good to know. Will ask to amend the order to both with and without contrast if they can. Since I do have an appt with an interventional vascular neuro … they will do the angio if needed… and timing wise, I should have ct results back before both appointments (skull base surgeon and vas neuro). TY ---
**Author:** ![Isaiah\_40\_31](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/isaiah_40_31/32/3054_2.png) [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)\ **Post date:** [April 26, 2023, 8:30pm UTC](https://forum.livingwitheagle.org/t/type-of-ct-for-ves/13272/6 "2023-04-26T20:30:50Z")
I should have said, a CT or other scan/test that checks for compression w/ the head in different positions is called dynamic testing. A test w/ head in neutral is static testing.